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EFUSI PLEURA PADA NODUL HEPAR MULTIPEL Widianti; Sedayu
Tunas Medika Jurnal Kedokteran & Kesehatan Vol 10 No 2 (2024): TUNAS MEDIKA JURNAL KEDOKTERAN & KESEHATAN
Publisher : Fakultas Kedokteran UGJ Cirebon

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33603/tumed.v10i2.9448

Abstract

Pendahuluan: Hepatocelullar carcinoma (HCC) merupakan tumor ganas hati primer yang berasal dari hepatosit, demikian pula dengan karsinoma fibromelar dan hepatoblastoma. Ilustrasi Kasus: Pasien perempuan 57 tahun datang ke rumah sakit dengan keluhan perut membesar 2 bulan yang lalu. Keluhan disertai nyeri pada bagian perut sebelah kanan atas, mual, sesak, sesak, penurunan nafsu makan serta penurunan berat badan. Pada pemeriksaan fisik didapatkan keadaan umum tampak sakit sedang, kesadaran composmentis. Tanda-tanda vital didapatkan TD 140/90 mmHg, HR 105x/menit, RR 22x/menit, suhu 36,7oC dan SpO2 97% free air. Pada pemeriksaan fisik, inspeksi abdomen didapatkan venektasi, hepatosplenomegali, ascites, pitting edem ekstremitas inferior. Pemeriksaan laboratorium didapatkan hipoalbumin, peningkatan ureum, penurunan alfafetoprotein. Pemeriksaan rontgen thorax : diafragma dextra letak tinggi ec suspek proses infradiafragma dextra. Pemeriksaan ultrasonografi (USG) abdomen : ascites, hepatomegali dengan multipel nodul di kedua lobus hepar DD proses hepatal metastasis dan splenomegali. Pemeriksaan CT-Scan abdomen : efusi pleura bilateral, ascites, hepatomegali dengan massa di lobus dextra (segmen IVa-VIII) disertai pelebaran ringan ductus bilier intrahepatal sinistra ec sugestif cholangiocarcinoma tipe mass forming, disertai multiple nodul di kedua lobus DD proses metastasis, splenomegali. Tatalaksana : pemberian furosemide, spironolakton, laktulosa sirup, analgetik, dan gomino. Pembahasan: Hepatocelullar carcinoma (HCC) adalah tumor hati primer yang merupakan penyebab kanker paling umum kelima di seluruh dunia. Faktor risiko yang signifikan untuk HCC termasuk hepatitis virus B dan C, penyakit hati alkoholik, dan Non-alcoholic fatty liver disease (NAFLD). Pada kasus ini pasien perempuan 57 tahun terdiagnosis sugestif HCC. Seperti kebanyakan penyakit kanker, kejadiannya meningkat seiring bertambahnya usia. Kesimpulan: Metastatis ekstrahepatik HCC yang paling umum adalah ke paru-paru, kelenjar getah bening inta-abdominal, tulang, dan adrenal. Kata Kunci: Hepatocelullar carcinoma, tumor, metastasis. ABSTRACT Introduction: Hepatocelullar carcinoma (HCC) is a primary liver malignant tumor that originates from hepatocytes, as well as fibromellar carcinoma and hepatoblastoma. Case Illustration: A 57-year-old female patient came to the hospital with complaints of an enlarged abdomen 2 months ago. Complaints accompanied by pain in the right upper abdomen, nausea, tightness, shortness of breath, decreased appetite and weight loss. On physical examination, it was found that the general condition appeared moderately ill, composmentis consciousness. Vital signs obtained BP 140/90 mmHg, HR 105x/min, RR 22x/min, temperature 36.7oC and SpO2 97% free water. On physical examination, abdominal inspection revealed venectation, hepatosplenomegaly, ascites, pitting edema of inferior extremities. Laboratory examination revealed hypoalbumin, increased urea, decreased alphafetoprotein. Thorax X-ray examination: high dextra diaphragm suspected dextra infradiaphragmatic process. Abdominal ultrasonography (USG) examination: ascites, hepatomegaly with multiple nodules in both hepatic lobes DD metastatic hepatal process and splenomegaly. CT-Scan examination of the abdomen: bilateral pleural effusion, ascites, hepatomegaly with a mass in the dextra lobe (segment IVa-VIII) accompanied by mild dilation of the intrahepatal biliary duct sinistra ec suggestive of mass forming type cholangiocarcinoma, accompanied by multiple nodules in both lobes DD metastatic process, splenomegaly. Management: furosemide, spironolactone, lactulose syrup, analgesic, and gomino. Discussion: Hepatocelullar carcinoma (HCC) is a primary liver tumor that is the fifth most common cause of cancer worldwide. Significant risk factors for HCC include viral hepatitis B and C, alcoholic liver disease, and Non-alcoholic fatty liver disease (NAFLD). In this case, a 57-year-old female patient was diagnosed with suggestive HCC. As with most cancers, the incidence increases with age. Conclusion: The most common extrahepatic metastasis of HCC is to the lungs, inta-abdominal lymph nodes, bone, and adrenal. Keywords: Hepatocelullar carcinoma, tumor, metastasis.
KEJADIAN SYSTEMIC LUPUS ERYTEMATOSUS PADA KEHAMILAN Tresna Ferdinan Fallah; Sedayu
Tunas Medika Jurnal Kedokteran & Kesehatan Vol 10 No 2 (2024): TUNAS MEDIKA JURNAL KEDOKTERAN & KESEHATAN
Publisher : Fakultas Kedokteran UGJ Cirebon

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33603/tumed.v10i2.9456

Abstract

Latar Belakang : Kejadian SLE di Indonesia, mengalami peningkatan dari tahun 2015 sebesar 17,9-27,2% menjadi 30,3-58% di tahun 2017.Tujuan: Membahas Kejadian Systemic Lupus Erytematosus pada Kehamilan dikarenakan bisa terjadinya abortus berulang sehingga harus dicurigai adanya APS. Metode : Melaporkan kasus seorang pasien berusia 30 tahun dengan keluhan ruam berwarna merah pada muka dan badan yang lama kelamaan berubah menjadi kehitaman serta memiliki riwayat keguguran yang berulang. Pasien di diagnosa Systemic Lupus Erythematosus sejak 2 tahun yang lalu dengan pengobatan Methylprednisolone, Imuran, asam folat, clopidogrel, bisoprolol, kalium dan Vitamin D. Kesimpulan : SLE merupakan penyakit autoimun multisistemik kronis. Kehamilan dengan SLE diperbolehkan jika telah mengalam masa remisi selama sekurangnya enam bulan. Selain itu, sangat penting dilakukan manajemen mulai dari perencanaan kehamilan hingga setelah persalinan dari berbagai multidisiplin. Kejadian abortus berulang pada pasien harus diperhatikan karena dapat terjadi sindrom antifosfolipid sehingga memperoleh tatalaksana yang berbeda. Kata kunci : systemic lupus erytematosus, kehamilan, abortus, autoimun Background: The incidence of Systemic Lupus Erythematosus (SLE) in Indonesia has increased from 17.9-27.2% in 2015 to 30.3-58% in 2017. Objective: To discuss the occurrence of Systemic Lupus Erythematosus during pregnancy due to the possibility of recurrent abortion, which should raise suspicion of Antiphospholipid Syndrome (APS). Method: Reporting a case of a 30-year-old patient with complaints of red rash on the face and body that gradually turned dark, and a history of recurrent miscarriages. The patient was diagnosed with Systemic Lupus Erythematosus two years ago and has been treated with Methylprednisolone, Imuran, folic acid, clopidogrel, bisoprolol, potassium, and Vitamin D. Conclusion: SLE is a chronic multisystem autoimmune disease. Pregnancy with SLE is permissible if the patient has been in remission for at least six months. Moreover, it is crucial to implement comprehensive management from pregnancy planning to postpartum care involving various multidisciplinary approaches. The occurrence of recurrent abortion in patients should be noted as it may indicate Antiphospholipid Syndrome and require different management. Keywords : Systemic lupus erythematosus, pregnancy, abortus, autoimun
Profil Nilai Laju Endap Darah (Led) Pada Pasien Tuberkulosis Dewasa Di Rsud Waled Periode 2022-2023 APRILIANINGTYAS, NUR ADILLA; NOVIANI, ISTI; SEDAYU
Hang Tuah Medical Journal Vol 23 No 1 (2025): Hang Tuah Medical Journal
Publisher : Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/htmj.v23i1.864

Abstract

Background: Tuberculosis (TB) is an infectious illness directly caused by Mycobacterium tuberculosis. Primarily, they impact the lungs (pulmonary tuberculosis), but they can also include other bodily organs (extrapulmonary tuberculosis). The erythrocyte sedimentation rate (ESR) test is a standard blood examination. The erythrocyte sedimentation rate measures the sedimentation velocity of erythrocytes in unclotted blood, expressed in mm/hour. During acute inflammation and infections, both acute and chronic, the erythrocyte sedimentation rate (ESR) may rise over its usual range. Objective: To acquire a comprehensive understanding of the erythrocyte sedimentation rate (ESR) in adult tuberculosis patients throughout Cirebon Regency. Methods: This study is a descriptive observational analysis carried out at Waled Hospital in Cirebon Regency. A research sample of 148 patients was acquired by complete sampling methodology utilizing secondary data from medical records. The data underwent univariate analysis. Results: Univariate analysis revealed that among 145 tuberculosis patients aged ≥18 years, 85 (58.6%) were male, whereas 60 (41.4%) were female. Out of 145 TB patients, 137 (94.5%) had pulmonary TB, while 8 (5.5%) had extrapulmonary TB. Additionally, 133 patients (91.7%) exhibited an elevation in erythrocyte sedimentation rate (ESR), with a minimum value of 4 mm/hour and a maximum of 140 mm/hour. Conclusion: Tuberculosis cases in individuals aged 18 years and older are predominantly male, with the highest incidence being pulmonary tuberculosis and an elevation in erythrocyte sedimentation rate (ESR).
Co-Authors APRILIANINGTYAS, NUR ADILLA Noviani, Isti Tresna Ferdinan Fallah Widianti