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Murdani Abdullah
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Divisi Gastroenterologi, Departemen Ilmu Penyakit Dalam, FKUI/RSUPN Dr. Cipto Mangunkusumo, Jl. Diponegoro No. 71 Jakarta 10430 Indonesia
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INDONESIA
The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Published by The Indonesian Society for Digestive Endoscopy
ISSN : 14114801     EISSN : 23028181     DOI : -
Core Subject : Health,
Medicine & Pharmacology
The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy is an academic journal which has been published since 2000 and owned by 3 Societies: The Indonesian Society of Gastroenterology; Indonesian Association for the Study of the Liver; The Indonesian Society for Digestive Endoscopy. The aim of our journal is to advance knowledge in Gastroenterology, Hepatology, and Digestive Endoscopy fields. We welcome authors for original articles, review articles, and case reports in the fields of Gastroenterology, Hepatology, and Digestive Endoscopy.
Arjuna Subject : Kedokteran - Ilmu Pencernaan
Articles 813 Documents
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The Role of Lipopolysaccharide-Binding Protein in Hepatitis B-Related Cirrhosis: Is There a Link to Portal Hypertension? Ety Febrianti; Suyata -; Legiran -; Imam Suprianto; Vidi Orba Busro; Muhamad Ayus Astoni; Anjab Akmal Sya'roni
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026111-118

Abstract

Background: Bacterial translocation plays a critical role in the pathogenesis of systemic inflammation in cirrhosis, particularly in cases related to chronic Hepatitis B infection. Lipopolysaccharide-binding protein (LBP) is a key acute-phase reactant that reflects exposure to endotoxins, yet its relationship with portal hypertension remains poorly defined. This study aimed to evaluate the correlation between serum LBP levels and spleen stiffness, a non-invasive marker of portal hypertension in patients with Hepatitis B-related cirrhosis. Methods: A cross-sectional study was conducted on 50 patients with Hepatitis B-related cirrhosis at Dr. Mohammad Hoesin Hospital, Palembang, between September and December 2024. Serum LBP levels were measured, and spleen stiffness was assessed using transient elastography. Laboratory parameters, clinical characteristics, and virologic profiles were analyzed. Correlation analyses were performed using Pearson’s or Spearman’s correlation tests, as appropriate.Results: The mean serum LBP level was 20.49 ± 7.34 μg/mL, while the mean spleen stiffness was 71.69 ± 17.74 kPa. A negative but non-significant correlation was observed between serum LBP levels and spleen stiffness (r = -0.263, p = 0.065). Serum LBP levels showed significant negative correlations with total, direct, and indirect bilirubin levels, as well as transaminase levels (AST and ALT), but not with platelet count, HBV DNA levels, or coagulation parameters.Conclusion: In patients with Hepatitis B-related cirrhosis, serum LBP may reflect systemic inflammatory activity rather than the severity of portal hypertension. Further studies are needed to determine its prognostic value in cirrhotic complications.
Inflammation and Its Pathophysiological Role in Functional Dyspepsia Christina Permata Shalim; I Ketut Mariadi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026165-172

Abstract

Many individuals worldwide suffer from functional dyspepsia (FD), a chronic digestive disorder characterized by symptoms in the absence of observable structural abnormalities within the gastrointestinal system. This condition significantly impacts the quality of life and healthcare expenditures. Although the precise etiology of FD remains incompletely understood, recent research indicates that low-grade inflammation, particularly within the duodenum, constitutes a substantial component of its pathophysiology. Such inflammation involves immune system dysregulation, activation of mast cells and eosinophils, and the secretion of pro-inflammatory cytokines, which collectively contribute to duodenal inflammation. This inflammatory response disrupts the enteric nervous system and elevates visceral hypersensitivity. Hypersensitivity and diminished gastric motility are associated with dysbiosis of the gut microbiota and Helicobacter pylori infection, and these associations are mediated via the gut-brain axis. Increasing evidence suggests that alterations in the duodenal microbiota may underlie immunological irregularities and FD. Recent therapeutic approaches, including probiotics, antihistamines, and leukotriene inhibitors, have demonstrated promise in addressing the inflammatory pathways implicated in FD. The purpose of this review is to examine current evidence concerning the role of inflammation in the pathogenesis of FD and to consider its potential implications for the development of novel therapeutic strategies. A deeper understanding of these underlying processes may facilitate the development of effective, targeted treatments, thereby improving patient outcomes.
The Role of Mastery Learning in Basic Skills in Upper Abdominal Ultrasound: Insights from a Comprehensive Training Workshop for Internists Lutfie Lutfie; Nikko Darnindro; Imelda Maria Loho; Steven David Panggabean; Ryan Herardi; Pitt Akbar; Bhanu Kumar; Rabbinu Rangga Pribadi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026134-140

Abstract

Background: Abdominal ultrasound is an essential competency for internists, although traditional workshop often lack structured learning strategies and measurable skill outcomes. To address this limitation, mastery learning offers deliberate practice, standardized assessment, and competency-based progression. However, the use of mastery learning in abdominal ultrasound training for internists remains limited. Therefore, this study aimed to evaluate the feasibility and effectiveness of applying mastery learning principles within a point-of-care basic upper abdominal ultrasound workshop designed for internists. Methods: A prospective study was conducted during the JIMDACE 2025 upper abdominal ultrasound workshop. Participants were subjected to pre- and post-training assessments across six targeted skills using a standardized checklist based on the Expert Performance Method. Subsequently, real-time feedback was provided during hands-on sessions. The scores obtained were analyzed using the Wilcoxon signed-rank test, followed by the calculation of effect size. Results: The results showed that the total scores of all 13 participants included in the final analysis improved from 1.750 (±1.571) at pre-test to 5 (range 0–6) at post-test. Furthermore, significant improvements were observed overall (p=0.001). Conclusion: The mastery learning-based workshop significantly improved abdominal ultrasound competence among internists, showing feasibility and strong educational impact. This method showed potential as a foundation for future structured ultrasound training programs.
Association of HER2 Expression with Clinical, Endoscopic, and Histopathological Features in Gastric Adenocarcinoma dr. Virly Nanda Muzellina, SpPD, K-GEH
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026107-110

Abstract

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Advances and Challenges in Budd-Chiari Syndrome Management: A Review of the Literature Darius Hartanto; Jeanne Winarta; Andrew Waleleng
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026173-181

Abstract

Budd-Chiari syndrome (BCS) is a medical condition caused by a partial or complete obstruction of hepatic venous outflow. Epidemiologically, BCS was considered rare, and its infrequent diagnosis was attributed to limited diagnostic tools and low clinical awareness. Therefore, this review aimed to enhance clinicians' awareness, from accurate diagnosis to appropriate management of patients with BCS. The symptoms experienced by patients ranged from asymptomatic cases to fulminant forms of the disease. Imaging methods, such as Doppler ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), were often used to establish the diagnosis. The primary treatment for BCS included anticoagulants, typically warfarin or low-molecular-weight heparin (LMWH). Depending on the patient's clinical status, more invasive therapeutic interventions could also be necessary.
Demographic Profile and Diagnostic Accuracy of the Pediatric Appendicitis Score in Children: A Retrospective Observational Study in A Tertiary Pediatric Intensive Care Unit Ririe Fachrina Malisie; Dedy Maks; Andre Andre; Atsushi Kawaguchi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026141-149

Abstract

Background: Acute appendicitis is a frequent cause of emergency surgery in children, but diagnosis can be challenging due to nonspecific clinical presentations, particularly in younger age groups. Therefore, this study aimed to describe the demographic characteristics of pediatric patients with suspected appendicitis, evaluate the diagnostic utility of the Pediatric Appendicitis Score (PAS), and the duration of postoperative care in the pediatric intensive care unit (PICU).Methods: This retrospective cross-sectional observational study included 15 pediatric patients with an acute abdomen who underwent exploratory laparotomy. PAS was applied, with histopathology as the reference standard, and postoperative PICU admission was performed for all patients. The variables collected were demographic data, PAS, histopathology results, and PICU length of stay. Diagnostic performance was also evaluated using sensitivity, specificity, predictive values, diagnostic accuracy, and area under the curve (AUC). Results: The results showed that histopathologically confirmed appendicitis was more common in older children and was associated with a higher mean. Using a cutoff value ≥6, PAS showed a sensitivity of 55.6% and specificity of 83.3%, while receiver operating characteristic analysis obtained moderate discriminative ability (AUC 0.704). Postoperative PICU length of stay tended to be shorter in confirmed cases, without statistical significance (p = 0.475). Conclusion: Pediatric appendicitis in the tertiary center predominantly affected children aged 5–18 years. The PAS showed moderate diagnostic accuracy, with good specificity but limited sensitivity. Although confirmed cases also tended to have shorter PICU stays, further studies comprising larger patient populations should be carried out to confirm and strengthen these results.
Alcohol-Associated Bowel Disease (ABD) in a Young Patient Presenting with Mixed Gastrointestinal Bleeding: A Case Report Agustien Bayu Ristanti; Muhammad Erlangga Putra Harimurti; Mohammad Amin Rais Perfernandi Ilham; Agastjya Wisjnu Wardhana
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026191-197

Abstract

Gastrointestinal (GI) bleeding is a common condition that can be life-threatening and requires prompt diagnosis and treatment. In younger adults without significant comorbidities, GI bleeding presents a diagnostic challenge, as it is uncommon and requires thorough evaluation to identify the underlying cause. Chronic excessive alcohol consumption is a significant yet often underrecognized risk factor. In recent studies, the term alcohol-associated bowel disease (ABD) has been introduced to describe GI problems mainly related to alcohol consumption. We present a case of a 29-year-old male with a history of chronic alcohol use who presented with melena and hematochezia. Laboratory evaluation revealed anemia and hypoalbuminemia, while abdominal ultrasonography revealed moderate fatty liver disease. Esophagogastroduodenoscopy confirmed erosive gastroduodenitis with a mucosal break greater than 5 mm, accompanied by esophageal candidiasis and grade B esophagitis. Meanwhile, colonoscopy confirmed the diagnosis of ulcerative colitis with active erosive ulcer bleeding. This case highlights severe mixed GI bleeding associated with chronic alcohol use, which may be classified as ABD. This case report aimed to demonstrate the importance of considering ABD in a relatively healthy young adult presenting with mixed and severe gastrointestinal bleeding
Gallbladder Polyps: Benign Bystanders or Malignant Precursors? Defining the Path from Detection to Treatment Darius Hartanto; Bradley Jimmy Waleleng; Luciana Rotty; Fandy Gosal; Jeanne Winarta; Andrew Waleleng
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026182-190

Abstract

Gallbladder polyps (GP) are defined as elevations of gallbladder wall that protrude into the lumen. These elevations are commonly detected incidentally during abdominal ultrasonography and predominantly asymptomatic. Based on malignant potential, gallbladder polyps are broadly classified into neoplastic and non-neoplastic types. Although most cases remain clinically silent, some patients may present with right upper quadrant pain, localized tenderness, and, in certain instances, a palpable mass in the upper abdomen. Abdominal ultrasound (US) remains the primary modality for both diagnosis and surveillance of gallbladder polyps. In general, a polyp size of ≥10 mm serves as a key threshold for considering cholecystectomy. However, additional risk factors such as age 60 years, primary sclerosing cholangitis, Asian ethnicity, and sessile morphology should also be considered in clinical decision-making. Therefore, this review aimed to enhance clinical awareness and inform appropriate management strategies for patients with gallbladder polyps.
Lower Gastrointestinal Tract Characteristics of Non-Hodgkin Lymphoma Maligna at Margono Soekarjo Purwokerto General Hospital: A Retrospective Descriptive Study Puan Faiza Nurianada; Hapsari Galih Setyowati; Lopo Triyanto; Mustofa -; Gita Nawangtantrini
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026150-154

Abstract

Background: Non-Hodgkin lymphoma (NHL) is one of the most common lymphoid neoplasms, frequently presenting with extranodal involvement, including the lower gastrointestinal tract and mesentery. Accurate diagnosis requires integration of clinical data, histopathological features, and immunohistochemical (IHC) markers. However, evidence regarding clinical characteristics and IHC profiles of NHL in these anatomical sites remains limited. Therefore, this study aimed to describe the clinical characteristics and IHC profile (CD20 and CD3) of NHL involving the lower gastrointestinal tract and mesentery at Margono Soekarjo Purwokerto General Hospital during 2022-2024. Methods: The experiment was conducted using a retrospective descriptive design with secondary data from medical records. The study population included patients diagnosed with NHL of the lower gastrointestinal tract and mesentery, fulfilling inclusion and exclusion criteria. Extracted variables comprised age, sex, residence, tumor site, and IHC results (CD20 and CD3). Subsequently, the data extracted were analyzed using univariate descriptive statistics. Results: The results showed that 40 patients met eligibility criteria, with the majority being 40–60 years (57.5%) and predominantly men (60%). Tumors were most frequently located in the caecum (32.5%) and mesentery (27.5%), with the majority of patients residing in Banyumas (25%). IHC analysis showed that 37 patients (92.5%) had CD20 positivity, consistent with B-cell NHL, while 3 patients (7.5%) expressed CD3 positivity, indicating T-cell NHL. Conclusion: Lower gastrointestinal and mesenteric NHL predominantly affected middle-aged men, most commonly involving the caecum, with B-cell type as the predominant subtype.
Chronic Hematochezia Caused by Amoebic Colitis with Multiple Flask-Shaped Colonic Ulcers: A Case Report Veronica Gosari; Maria Gabrielle Simadibrata; Randy Adiwinata; Paulus Simadibrata; Saut H. H. Nababan; Ardiana Hendrasti; Cosmas Rinaldi Adithya Lesmana
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026198-203

Abstract

Chronic hematochezia is a clinical presentation with a broad differential diagnosis. Among infectious causes of hematochezia, amoebic colitis due to Entamoeba histolytica requires early consideration, particularly in tropical and endemic regions. However, the diagnosis of amoebic colitis is often challenging due to the limited sensitivity of stool examination, leading to delayed treatment. Therefore, this case report aims to explore the limitations of stool examination and emphasize the important role of colonoscopy and histopathology in establishing the diagnosis of amoebic colitis in patients with persistent symptoms. The diagnostic challenge was shown by the case of a 49-year-old man presenting with hematochezia for more than one month, accompanied by intermittent fever and abdominal bloating. Initial stool examination showed numerous erythrocytes and leukocytes, but no trophozoites or cysts of E. histolytica were identified. Due to persistent symptoms, colonoscopy was performed and showed pancolitis with multiple large irregular ulcers covered with friable debris that bled easily throughout the colon. Histopathological examination confirmed the presence of flask-shaped ulcers containing amoebic trophozoites, establishing the diagnosis of amoebic colitis. The patient was treated with metronidazole 750 mg three times daily for 10 days, resulting in complete resolution of hematochezia. This case showed that a negative stool examination did not exclude amoebic colitis. In patients with high clinical suspicion and persistent symptoms, colonoscopy and histopathological evaluation played a crucial role in confirming the diagnosis and enabling timely treatment. This report also showed the importance of a comprehensive diagnostic method to prevent delays in the management of amoebic colitis in endemic regions.

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