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7/21/2019 Referat Rara Abses Hepar
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LAPORAN KASUS DAN REFERAT
“ABSES HEPAR”
OLEH :
Habibi
1102007132
Pembimbing : !" Fi!man#$a%& S'B
KEPANITERAAN KLINIK ILMU BEDAH
RUMAH SAKIT UMUM RIDWAN MAUREKSA
FAKULTAS KEDOKTERAN UNIVERSITAS YARSI
2016
7/21/2019 Referat Rara Abses Hepar
http://slidepdf.com/reader/full/referat-rara-abses-hepar 2/18
PENDAHULUAN
Abses ha! a"a#ah be$%& !$'e&s! (a"a ha! )a$* "!sebab&a$ +#eh &a,e$a
!$'e&s! ba&e,!- (a,as!- .a/%, /a%(%$ $e&,+s!s se,!# )a$* be,s%/be, "a,! s!se/
*as,+!$es!$a# )a$* "!a$"a! "e$*a$ a"a$)a (,+ses s%(%,as! "e$*a$
(e/be$%&a$ (%s )a$* e,"!,! "a,! .a,!$*a$ ha! $e&,+!&- se#se# !$'#a/as! aa% se#
"a,ah "! "a#a/ (a,e$&!/ ha! 1-2
Abses ha! e,ba*! 2 sea,a %/%/- )a!% abses ha! a/+eb! 3AHA4 "a$ abses
ha! (!+*e$!& 3AHP5 Hepatic Abcess, Bacterial Liver Abcess4 AHA /e,%(a&a$
sa#ah sa% &+/(#!&as! a/+eb!as!s e&s,a!$es!$a# AHA e,%a/a "!sebab&a$ +#eh
Entamoeba Histolytica. 2
AHP "!&e$a# .%*a seba*a! hepatic abscess, bacterial liver abscess,
bacterial abscess of the liver, bacterial hepatic abscess AHP !$! /e,%(a&a$ &as%s )a$*
,e#a!' .a,a$* AHP !$! e,seba, "! se#%,%h "%$!a- "a$ e,ba$)a& "! "ae,ah ,+(!s
"e$*a$ &+$"!s! h!*!e$e5sa$!as! )a$* &%,a$* 2
P,ea#e$s! )a$* !$**! sa$*a e,a h%b%$*a$$)a "e$*a$ sa$!as! )a$*
b%,%&- sa%s e&+$+/! )a$* ,e$"ah se,a *!7! )a$* b%,%& Me$!$*&a$)a a,%s%,ba$!sas! /e$)ebab&a$ be,a/bah$)a &as%s abses ha! "! "ae,ah (e,&+aa$ D!
$e*a,a )a$* se"a$* be,&e/ba$* abses ha! a/%ba #eb!h se,!$* "!"a(a&a$ sea,a
e$"e/!& "!ba$"!$*&a$ "e$*a$ abses ha! (!+*e$!& 2
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ANATO() DAN F)S)OLO*) HEPAR
Ha! a"a#ah &e#e$.a, e,besa, "a#a/ %b%h- be,a ,aa,aa se&!a,
1800*, aa% 2 9 be,a ba"a$ +,a$* "easa $+,/a# Lea&$)a seba*!a$ besa, "!
,e*!+ h!(+&+$",!a "e&s,a- e(!*as,!&a- "a$ seba*!a$ &e!# "! h!(+&+$",!a
s!$!s,a Ha! /e/!#!&! "%a #+b%s %a/a )a!% &a$a$ "a$ &!,! L+b%s &a$a$
"!ba*! /e$.a"! se*/e$ a$e,!+, "a$ (+se,!+, +#eh '!s%,a se*/e$a#!s &a$a$
L+b%s &!,! "!ba*! /e$.a"! se*/e$ /e"!a# "a$ #ae,a# +#eh #!*a/e$%/
'a#s!'+,/!s D! baah (e,!+$!%/ e,"a(a .a,!$*a$ !&a (a"a )a$* "!seb%
kapsula Glisson )a$* /e#!(%! se#%,%h (e,/%&aa$ ha! Se!a( #+b%s ha!
e,ba*! /e$.a"! s,%&%,s,%&%, )a$* "!seb% seba*a! #+b%#%s- )a$*
/e,%(a&a$ %$! /!&,+s&+(!s "a$ '%$*s!+$a# +,*a$ )a$* e,"!,! aas #e/(e$*
#e/(e$* se# ha! "!/a$a "!a$a,a$)a e,"a(a s!$%s+!" Se#a!$ se#se# ha!-
s!$%s+!" e$a "!#a(!s! +#eh se# e$"+e# &h%s%s "a$ se# Kupffer )a$* /e,%(a&a$
/a&,+'a* )a$* /e#a(!s! s!$%s+!" "a$ /a/(% /e/'a*+s!+s!s ba&e,! "a$
be$"a as!$* #a!$ "a#a/ "a,ah s!$%s he(a!&%s Ha! /e/!#!&! s%(#a! "a,ah "a,!
sa#%,a$ e,$a "a$ #!/(a /e#a#%! e$a (+,a he(a!&a "a$ "a,! a+,a /e#a#%!
a,e,!a he(a!&a 32-;-<4
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Ha! /e/(%$)a! '%$*s! )a$* sa$*a be,a$e&a ,a*a/ Bebe,a(a "! a$a,a$)a
)a!%: 3;-<-84
Pemben+,-an an e-#-!e#i em'e,
Da#a/ ha# !$! e,.a"! /eab+#!s/e (!*/e$ "a$ *a,a/ e/(e"% =a,a/ e/(e"%
(e$!$* %$%& (e$e,$aa$ "a$ abs+(s! #e/a& se,a !a/!$ #a,%#e/a& "!
"a#a/ %s%s
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'!.+ein #e+e/a% 'en$e!a'an a!i #a/,!an 'ene!naan
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se,a !$e,&+$e,s! be,a*a/ asa/ a/!$+ "a$ s!$es!s se$)aa #a!$ "a,!
asa/ a/!$+
Penimb,nan i+amin an mine!a/
V!a/!$ #a,%#e/a& 3 A-D-E-K 4 "!s!/(a$ "a#a/ ha!- .%*a !a/!$ B12-
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"!s!/(a$ "a#a/ ha! a"a#ah !a/!$ A- ea(! se.%/#ah besa, !a/!$ D "a$
B12 .%*a "!s!/(a$ sea,a $+,/a#
Hati menyimpan besi dalam bentuk ferritin
Se# ha! /e$*a$"%$* se.%/#ah besa, (,+e!$ )a$* "!seb% apoferritin- )a$*
"a(a be,*ab%$* "e$*a$ bes! ba!& "a#a/ .%/#ah se"!&! /a%(%$ ba$)a&
O#eh &a,e$a !%- b!#a bes! ba$)a& e,se"!a "a#a/ a!,a$ %b%h- /a&a bes!
a&a$ be,!&aa$ "e$*a$ a(+'e,,!!$ /e/be$%& 'e,,!!$ "a$ "!s!/(a$ "a#a/
be$%& !$! "! "a#a/ se# ha! sa/(a! "!(e,#%&a$ B!#a bes! "a#a/ s!,&%#as!
a!,a$ %b%h /e$a(a! &a"a, ,e$"ah- /a&a 'e,,!!$ a&a$ /e#e(as&a$ bes!
Hati membentuk zatzat yan! di!unakan untuk koa!ulasi darah dalam
"umlah banyak
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bebe,a(a 'a&+, &+a*%#as! #a!$$)a V!a/!$ K "!b%%h&a$ +#eh (,+ses
/eab+#!s/e ha!- %$%& /e/be$%& (,+,+/b!$ "a$ 'a&+, VII- I?- "a$ ?
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)a$* "!se&,es! +#eh &e#e$.a, e$"+&,!$ "!e&s&,es! aa% "!ha/ba sea,a &!/!a
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Ha+i be!6,ng#i #ebagai g,ang a!a% an 6i/+!a#i
Ha! a"a#ah +,*a$ e$+sa )a$* /a/(% be&e,.a seba*a! e/(a (e$a/(%$*a$
"a,ah )a$* be,/a&$a saa +#%/e "a,ah be,#eb!ha$ "a$ /a/(% /e$)%(#a!
"a,ah e&s,a "! saa &e&%,a$*a$ +#%/e "a,ah S!$%s+!" ha! /e,%(a&a$ "e(+
"a,ah )a$* /e$*a#!, &e/ba#! "a,! e$a aa 3*a*a# .a$%$* &a$a$4 &e,.a
'a*+s!!& se# K%(''e, /e/b%a$* ba&e,! "a$ "eb,!s "a,! "a,ah
ET)OLO*) DAN PATO*ENES)S
Ab#e# Ha+i Am,ba
E. Histolytica /e/(%$)a! "%a be$%&- )a&$! ,+'+7+! "a$ &!saBe$%&
&!sa /e,%(a&a$ s%/be, (e$%#a,a$ "a$ /as%& &e "a#a/ %b%h ,$e#a#%! /a&a$a$
aa% /!$%/a$ Da#a/ %s%s- be$,%& &!sa !$! be,%bah /e$!a"! ,+'+7+!" T,+'+7+!
&e,$%"!a$ be,&e/ba$*- b!#a /e$e/b%s /%&+sa- ,+'+7+! /e$)ebab&a$ %&a&
(a"a /%&+sa &+#+$ Abses a/%ba ha! e,.a"! &a,e$a ,+'+7+! Eh!s+#)!a "a,!
"!$"!$* %s%s e,baa a#!,a$ e$a (+,a &e ha! e,a(! !"a& se/%a a/%ba )a$*
/as%& &e ha! "a(a /e$!/b%#&a$ abses A*a, e,.a"! abses-"!(e,#%&a$ 'a&+,
(e$"%&%$* aa% (e$*ha#a$* be,&e/ba$* b!a&$)a a/%ba e,seb% Fa&+, e,seb%
a$a,a #a!$ a"a#ah ,!a)a !$'e&s! a/%ba- !$**!$)a &a"a, &+#es,e,+#- ,!a)a
(asa ,a%/a ha!- "a$ &ea*!ha$ a#+h+# Te,.a"! ,ea&s! ,a"a$* "! ha!- )a$*
a&h!,$)a "!!&%! +#eh $e&,+s!s .a,!$*a$ (,+ses (e$a!,a$ .a,!$*a$ $e&,+s!s
/%#!(#e )a$* se/a&!$ #a/a se/a&!$ besa, !$! &e/%"!a$ be,*ab%$*- /e/be$%&
abses )a$* be,!s! a!,a$ /e,ah +&#a 3a$hh%) sa%e4 a& be,ba%- &a,e$a
/e,%(a&a$ (,+"%& #!s!s .a,!$*a$ $e&,+s!s "a$ (e,"a,aha$ @a!,a$ !$! e,b%$*&%s+#eh h)(e,(#as!a .a,!$*a$ !&a )a$* "!seb% s!/(a! a#a%(%$ b%&a$ be,%(a s!/a(!
se.a! .a,!$*a$ !&a !$! /e/baas! (e,%sa&a$ #eb!h .a%h- &e%a#! b!#a a"a !$'e&s!
a/bah$ Se# ha! .a%h "a,! '+%s !$'e&s! .%*a /e$*a#a/! se"!&! (e,%baha$
/es&!(%$ !"a& "!e/%&a$ a/%ba Pe,%baha$ !$! "!"%*a a&!ba +&s!$ )a$*
"!&e#%a,&a$ +#eh a/%ba Keba$)a&a$ abses ha! be,s!'a s+#!e,- se,!#- "a$ e,#ea&
"! #+b%s &a$a$ "e&a "e$*a$ &%bah "!a',a*/a .a,a$* "!e/%&a$ a/%ba (a"a
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s!/(a!$)a
Ab#e# Pi.geni-
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"!sebab&a$ +#eh ,a%/a aa% !$'e&s! #a$*s%$* ha! aa% s!se/ "! se&!a,$)a
Sebe#%/ e,a a$!b!+,!&- se(s!s !$,aab"+/e$- e,%a/a a(e$"!s!!s- "!e,!&%#!!s-
"!se$,! bas!#e,- !$'e&s! "ae,ah (e#!&- he/+,+!" )a$* e,!$'e&s!- "a$ abses
(e,!,e&a#- /e,%(a&a$ (e$)ebab %a/a abses ha! (!+*e$!& B!asa$)a be,aa#
seba*a! (!#e'#eb!!s (e,!'e, "!se,a! (e,$a$aha$ "a$ ,+/b+s!s )a$* &e/%"!a$
/e$)eba, /e#a#%! a#!,a$ (+,a &e "a#a/ ha! Abses ha! "a(a ,e,.a"! a&!ba
(e$)eba,a$ #a$*s%$* !$'e&s! "a,! s,%&%, )a$* be,"e&aa$ se(e,! e/(!e/a
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&+#e#!!as!s aa% &a,s!$+/a /e,%(a&a$ (e$)ebab %a/a abses ha! (!+*e$!&
K+#es!s!!s a&% "a$ (a$&,ea!!s a&% .%*a "a(a /e$)ebab&a$ abses ha!
(!+*e$!& I$'e&s! (a"a sa#%,a$ e/(e"% )a$* /e$*a#a/! +bs,%&s! $a!& &e aba$*
sa#%,a$ e/(e"% !$,ahe(a!& /e$)ebab&a$ &+#a$*!!s )a$* /e$!/b%#&a$
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a!,a$ e/(e"% )a$* /%"ah ,e,!$'e&s! He/a+/a s%b&a(s%#e, "a(a .%*a
/e$*a&!ba&a$ !$'e&s! "a$ /e$!/b%#&a$ abses )a$* s+#!e, "a$ e,#+&a#!sas!
Seba*!a$ &e!# "!sebab&a$ !$"a&a$ "!a*$+s!& aa% e,a(e%!& Te,.a"!$)a abses (asa ,a%/a sa$*a *a$%$* (a"a &%a#!as (e/be"aha$ )a$* "!#a&%&a$ %$%&
/e$a$**%#a$*! ,a%/a ha! sebe#%/$)a Se(s!s "e$*a$ (e$)eba,a$ /e#a#%!
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/a%(%$ .a,!$*a$ ha! a&a$ /%"ah /e$*%$"a$* !$'e&s! se&%$"e, "a$
/e$!/b%#&a$ abses )a$* b!asa$)a s+#!e, K!sa "! "a#a/ .a,!$*a$ ha! .%*a "a(a
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/e$*a#a/! !$'e&s! se&%$"e, seba*a!/a$a &e#a!$a$ ha! )a$* !a!$ se(e,!
s!s+s+/!as!s- %be,&%#+s!s- as&a,!as!s "a$ (e$)a&! h!"a!"+sa 3&!sa e&!$+&+&%s4
Abses ha! (!+*e$!& "a(a !/b%# seba*a! (e$)%#! (a$&,ea!!s &,+$!& Abses ha!
(!+*e$!& /%#!(#e e,"a(a (a"a 809 &as%s Ha! a/(a& /e/be$*&a& "a$ "ae,ah
)a$* /e$*a$"%$* abses /e$.a"! (%a &e&%$!$*a$- be,be"a "e$*a$ ha! seha "!
se&!a,$)a )a$* be,a,$a /e,ah %a Keba$)a&a$ e,"a(a (a"a I+b%s &a$a$
"e$*a$ (e,ba$"!$*a$ #!/a &a#! #+b%s &!,! A(ab!#a abses ha! (!+*e$!&
be,h%b%$*a$ "e$*a$ (!#e'eb!!s- (+,a "a$ aba$*$)a a/(a& /e#eba, "a$
/e$*a$"%$* $a$ah- be&%a$ "a,ah- "a$ bae,!a D! se&!a, abses e,"a(a !$'!#,as!
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$a$ah )a$* be,a,$a h!.a% Ha/(!, se/%a +,*a$!s/e (a+#+*!& "a(a
/e$!/b%#&a$ abses ha! (!+*e$!& Ya$* e,(e$!$* !a#ah E +#!- Sa(h)#++%s
a%,es%s- P,+e%s- &#ebs!e##a- Pse%"+/+$as- "a$ ba&e,!a a$ae,+b- se(e,!
Bae,+!"es "a$ @#+s,!"!%/ Pa"a "%a (e,!*a &as%s "a(a "!b!a&&a$ #eb!h "a,!
sa% +,*a$!s/e Ke%,!*aa$ &%/a$ a$ae,+b #eb!h besa, b!#a "!"a(a $a$ah )a$*
be,ba% b%s%&- *as "a#a/ abses- "a$ !"a& a"a &%/a$ (a"a (e/b!a&a$ ae,+b
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%be,&%#+s!s aa% !$'esas! as&a,!s B!#a +,*a$!s/e S,e(++%s /!##e!,! "a(a
"!b!a&&a$ "a#a/ "a!ah- "a(a "!"%*a a"a abses ha! )a$* !"a& a/(a& 3abses
e,sa/a,4C
(AN)FESTAS) KL)N)S
Ab#e# He'a! Am.eba
Pe$)a&! !$! !/b%# sea,a (e,#aha$- "!se,a! "e/a/-be,&e,!$*a- "a$ be,a ba"a$/e$%,%$ Sebe#%/ !/b%# abses ha,! se#a#% "!"ah%#%! +#eh !$'e&s! %s%s D!a,e a&!'
ha$)a e,.a"! &%,a$* "a,! ;09 =e.a#a aa# $)e,! ab"+/e$ &a$a$ aas "!se,a!
(a$as N)e,! /e$.a#a, (a"a bah% &a$a$ "a$ s&a(%!a &a$a$ a&!ba, !,!as! "!a',a*/a
"a$ #e,a/bah "e$*a$ ba%& "a$ $a(as "a#a/ Ta$"a #+&a# )a$* (a#!$* se,!$*
$)e,! e&a$ "! "ae,ah #e$*&%$* !*a "e$*a$ ha! )a$* /e/besa, He(a+/ea#!
"a$ $)e,! b!asa$)a "!e/%&a$- ea(! .a,a$* se&a#! "!se,a! !&,e,%s- (,e&+/a- aa%
&+/a B!#a #+b%s &!,! )a$* e,&e$a- a&a$ "!e/%&a$ /assa "! "ae,ah e(!*as,!%/
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=e.a#a &has a"a#ah s%h% %b%h )a$* Ieb!h "a,! ;-8@ (e$"e,!a a& &e#!ha,a$ sa&!
be,a se(e,! (a"a abses &a,e$a ba&,e,!C
Ab#e# Pi.geni-
Sea,a &#!$!s- *e.a#a $+$s(es!'!& )a$* !/b%# /e#!(%! "e/a/ )a$* $a!& %,%$-
/a#a!se- /%a#- ,asa #e/ah- a$+,e&s!a- (e$%,%$a$ be,a ba"a$- $)e,! &e(a#a- $)e,!
++ "a$ se$"!- se,a $)e,! (e,% N)e,! (e,% e,%a/a "!,asa&a$ "! baah !*a
&a$a$ aa% (a"a &%a",a$ &a$a$ aas Da(a "!.%/(a! *e.a#a "a$ a$"a e'%s! (#e%,a
B!#a e,be$%& "e&a "!a',a*/a- "a(a !/b%# *e.a#a $)e,! se(e,! (#e%,!!s "e$*a$
ba%& "a$ sesa& N)e,! se,!$* be,&%,a$* b!#a (e$"e,!a be,ba,!$* (a"a s!s! &a$a$
De/a/ h!#a$* !/b%# aa% /e$ea( be,*a$%$* (a"a .e$!s abses "a$ &%/a$
(e$)ebab$)a Da(a e,.a"! !&e,%s- as!es- "a$ "!a,e I&e,%s e,%a/a e,"a(a
(a"a abses ha! (!+*e$!& &a,e$a (e$)a&! sa#%,a$ e/(e"% )a$* "!se,a! "e$*a$
&+#a$*!!s s%(%,a!a "a$ (e/be$!%&a$ abses /%#!(#e e$!s !$! (,+*$+s!s$)a
b%,%& Pa"a (e/e,!&saa$ /%$*&!$ "!"a(a he(a+/e*a#! aa% &ee*a$*a$ (a"a
(e,% &%a",a$ #ae,a# aas ab"+/e$ aa% (e/be$*&a&a$ (a"a "ae,ah !$e,&+sa#
Kee*a$*a$ #eb!h $)aa (a"a (e,&%s! A(ab!#a abses e,"a(a (a"a #+b%s &!,!-
/%$*&!$ "a(a "!,aba %/+, "! e(!*as,!%/ Da(a e,.a"! (e$)%#! be,%(a
(eah$)a abses &e "a#a/ ,+$**a (e,%- ,+$**a "a"a- aa% (e,!&a," Da(a (%#a
e,.a"! se(!se/!a "a$ s)+& A&a$ ea(!- ba$)a& ba$)a& .%*a !"a& /e$%$.%&&a$
*e.a#a &has O#eh &a,e$a !%- &e/%$*&!$a$ abses ha! (!+*e$!& (a% "!(!&!,&a$
(a"a se!a( (e$"e,!a "e$*a$ "e/a/ a$(a sebab )a$* .e#as- e,%a/a (asabe"ah
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7/21/2019 Referat Rara Abses Hepar
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D)A*NOS)S
A/g.!i+ma 'enega--an iagn.#i#
7/21/2019 Referat Rara Abses Hepar
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Peme!i-#aan Lab.!a+.!i,m
Pa"a (as!e$ abses ha! a/eb!&- (e/e,!&saa$ he/a+#+*! "!"a(a&a$
he/+*#+b!$ 10-<11-; *9 se"a$*&a$ #e&+s! 18000160005/L; (a"a
(e/e,!&saa$ 'aa# ha! "!"a(a&a$ a#b%/!$ 2-C6;-08 *9- *#+b%#!$ ;-62
;-C8 *9- +a# b!#!,%b!$ 0-2-<< /*9- '+s'aase a#&a#! 2C0-<;2-0 %5L-
S=OT 2C-88- %5L "a$ S=PT 18-C6;-0 %5L a"! &e#a!$a$ )a$*
"!"a(a&a$ (a"a a/%b!as!s ha! a"a#ah a$e/!a ,!$*a$ sa/(a! se"a$*-
#e%&+s!+s!s be,&!sa, 180005/L; Se"a$*&a$ &e#a!$a$ 'aa# ha! "!"a(a&a$
,!$*a$ sa/(a! se"a$* U.! se,+#+*! "a$ %.! &%#! )a$* (+s!!' /e$%$.%&&a$
a"a$)a A* aa% Ab )a$* s(es!'!& e,ha"a( (a,as! !$!- &e%a#! (a"a aa#
!$'e&s! A"a bebe,a(a %.! )a$* ba$)a& "!*%$a&a$ a$a,a #a!$
hema!lutination 3IHA4- countermunoelectrophoresis 3@IE4- "a$ ELISA
#eal $ime %&# ++& %$%& /e$"ee&s! Eh!s+#!)a (a"a 'eses "a$ (%s
(e$"e,!a abses he(a, 2-C
Pa"a (as!e$ abses ha! (!+*e$!&- /%$*&!$ "!"a(a&a$ #e%&+s!+s!s
"e$*a$ (e,*ese,a$ &e &!,!- a$e/!a- (e$!$*&aa$ #a.% e$"a( "a,ah-
*a$**%a$ '%$*s! ha! se(e,! (e$!$**!a$ b!#!,%b!$- a#&a#!$ '+s'aase-
(e$!$*&aa$ e$7!/ ,a$sa/!$ase- se,%/ b!#!,%b!$- be,&%,a$*$)a
&+$se$,as! a#b%/!$ se,%/ "a$ a&% (,+,+/b!$ )a$* /e/a$.a$*
/e$%$.%&&a$ baha e,"a(a &e*a*a#a$ '%$*s! ha! K%#%, "a,ah )a$*
/e/(e,#!ha&a$ ba&e,!a# (e$)ebab /e$.a"! sa$"a, e/as %$%&
/e$e*a&&a$ "!a*$+s!s sea,a /!&,+b!+#+*!& Pe/e,!&saa$ b!a&a$ (a"a
(e,/%#aa$ (e$)a&! se,!$* !"a& "!e/%&a$ &%/a$ K%/a$ )a$* se,!$*
"!e/%&a$ a"a#ah &%/a$ *,a/ $e*a!' se(e,! %roteus vul!aris, Aerobacter aero!enes aa% %seudomonas aeru!inosa, se"a$*&a$ &%/a$
a$ae,!b 'icroaerofilic sp, (treptococci sp, Bacteroides sp, aa%
)usobacterium sp. 1-2
Peme!i-#aan Rai./.gi
Pa"a (as!e$ abses ha! a/eb!&- '++ h+,a&s /e$%$.%&&a$
(e$!$**!a$ &%bah "!a',a*/a &a$a$ "a$ be,&%,a$*$)a (e,*e,a&a$
"!a',a*/a e'%s! (#e%,a &+#a(s (a,% "a$ abses (a,% Ke#a!$a$ (a"a '++
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7/21/2019 Referat Rara Abses Hepar
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(+#+s ab"+/e$ !"a& be*!% ba$)a& M%$*&!$ be,%(a *a/ba,a$ !#e%s-
he(a+/e*a#! aa% *a/ba,a$ %"a,a bebas "! aas ha! a,a$* "!"a(a&a$
a!, '#%!" #ee# )a$* .e#as- US= %$%& /e$"ee&s! a/%b!as!s ha!- US=
sa/a e'e&!'$)a "e$*a$ @T aa% MRI =a/ba,a$ US= (a"a a/%b!as!s
ha! a"a#ah be$%& b%#a aa% +a# !"a& a"a *e/a "!$"!$* )a$* be,a,!
e&+*e$!as #eb!h ,e$"ah "a,! (a,e$&!/ ha! $+,/a# be,se$%ha$ "e$*a$
&a(s%# ha! "a$ (e$!$**!a$ sonic distal. =a/ba,a$ @T sa$ : 8 9 be,%(a
/assa s+#!e, ,e#a!' besa,- /+$+#+&%#a,- (,a&+$,as a/(a& seba*a! /assa
h!(+"e$s be,baas s%,a/ De$s!as a!,a$ abses be,&!sa, 1020 HU Pasa
&+$,as a/(a& (e$)e$*aa$ (a"a "!$"!$* abses )a$* eba# Se(a e,#!ha
(a"a ;0 9 &as%s Pe$)e$*aa$ "!$"!$* e,#!ha ba!& (a"a 'ase (+,a 2
Gambaran CT Scan pada abses hati amebic
Pa"a (as!e$ abses ha! (!+*e$!&- '++ (+#+s ab"+/e$ &a"a$*&a"a$*
"!"a(a&a$ &e#a!$a$ )a$* !"a& s(es!'!& se(e,! (e$!$**!a$ "!a',a*/a
&a$a$- e'%s! (#e%,a- ae#e&as!s basa# (a,%- e/(!e/a- aa% abses (a,% Pa"a
'++ h+,a&s PA- s%"% &a,"!+',e$!&%s e,%%(- (a"a (+s!s! #ae,a# s%"%
&+s+',e$!&%s a$e,!+, e,%%( Sea,a a$*!+*,a'!& abses /e,%(a&a$
"ae,ah aas&%#e, Ka"a$*&a"a$* "!"a(a&a$ *as aa% a!,a$ (a"a
s%b"!a',a*/a &a$a$ Pe/e,!&saa$ US=- ,a"!+$%#!"e sa$$!$*- @T sa$
"a$ MRI /e/(%$)a! $!#a! "!a*$+s!s )a$* !$**! @T sa$ "a$ MRI "a(a
/e$ea(&a$ #+&as! abses #eb!h a&%,a e,%a/a %$%& ",a!$ase (e,&%a$
aa% !$"a&a$ be"ah =a/ba,a$ @T sa$ : a(ab!#a /!&,+abses be,%(a #es!
h!(+"e$s &e!#&e!# G 8 // s%&a, "!be"a&a$ "a,! /!&,+abses .a/%,- ,!/
e$ha$e/e$ (a"a /!&,+abses s%&a, "!$!#a! &a,e$a #es! e,#a#% &e!#
A(ab!#a /!&,+abses 10 // aa% /e/be$%& &#%se, seh!$**a a/(a&
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/assa a*a& besa, /a&a (,a&+$,as &#%se, (!+*e$!& abses a/(a& seba*a!
/asa lo* density be,baas s%,a/ Pasa &+$,as 'ase a,e,!a# a/(a&
*a/ba,a$ &has be,%(a /asa "e$*a$ rim enhancement "!/a$a ha$)a
&a(s%# abses )a$* eba# )a$* /e$)e$*a Ba*!a$ e$*ah abses e,#!ha
h!(+"e$s "e$*a$ ba$)a& se(ase(a ha#%s )a$* .%*a /e$)e$*a- seh!$**a
/e/be$%& *a/ba,a$ /e$)e,%(a! .a#a Fase (+,a (e$)e$*aa$ "!$"!$*
&a(s%# abses a&a$ se/a&!$ /e$+$.+# "a$ se&!a, "!$"!$* abses a/(a&
a,ea )a$* h!(+"e$s seba*a! ,ea&s! e"e/a "! se&!a, abses Seba*!a$ &e!#
(!+*e$!& be,s!'a /+$+&%#e,- !"a& be,se(a- "a$ /e$)e,%(a! abses
a/+eb!as!s Pe/be$%&a$ *as "! "a#a/ abses b!asa$)a (a"a !$'e&s! +#eh
&%/a$ K#ebs!e##a 1-2
Gambaran CT Scan dengan multifokal abses hati piogenik pada segmen IV. Abseslainnya terdapat pada segmen VII dan VIII )
Ka,ae,!s!& abses (a"a (e/e,!&saa$ MRI a"a#ah #es! "e$*a$
(e$)e$*aa$ &+$,as )a$* be,be$%& !$!$ "a$ ba*!a$ se$,a# )a$* !"a&
a/(a& (e$)e$*aa$ @!$!$ (e$)e$*aa$ ea( e,#!ha (a"a 'ase %$"a
Sa$*a s%&a, "!be"a&a$ *a/ba,a$ US= a$a,a abses (!+*e$!& "a$ a/eb!&
B!asa$)a sa$*a besa,- &a"a$*&a"a$* /%#!#+&%#a, S,%&%, e&+ ,e$"ah
sa/(a! a!,a$ 3a$e&+!&4 "e$*a$ a"a$)a be,a&be,a& h!(e,e&+!& 3"eb,!s4
"! "a#a/$)a Te(!$)a e*as- !,e*%#e, )a$* /a&!$ #a/a /a&!$ be,a/bah
eba# 2
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D)A*NOS)S BAND)N*
Pe$)a&! #a!$ )a$* *e.a#a$)a /!,!( "e$*a$ abses he(a, a$a,a #a!$- &+#es!s!!s
a&%- he(a!!s !,%s a&%- he(a+/a $e&,+!&- "a$ &a,s!$+/a (,!/e, !(e 'eb,!#
U$%& /e/as!&a$ "!a*$+s!s- (e,#% "!#!ha has!# (e/e,!&saa$ %#,as+$+*,a'!-
(%$*s!- "a$ (e,+baa$ (e$*+baa$ "e$*a$ a/%b!s!" )a$* /e,%(a&a$ "!a*$+s!s
(e, e&s#%s!+$e/C
TATALAKSANA
Me,+$!"a7+# /e,%(a&a$ +ba (!#!ha$ "e$*a$ "+s!s ; &a#! C80 /*!a(
ha,!$)a (a"a +,a$* "easa- "a$ ;880 /*5 &*bb "!ba*! "a#a/ ; "+s!s (a"a
a$a&-"!be,!&a$ se#a/a 6 ha,! B!#a !"a& "a(a "!be,!&a$ (e, +,a#- +ba "a(a
"!be,!&a$ /e#a#%! (a,e$e,a# !$,ae$a seba$)a& 800 /* !a( 12 .a/ Se&!a,
<9 (e$"e,!a /e$%$.%&&a$ )a$* ba!& "a#a/ C2 .a/ K#+,+&%!$ '+s'aase
/e,%(a&a$ a$!a/%ba e&s,a!$es!$a# "a$ "!be,!&a$ "a#a/ "+s!s 1 *,a/ !a( ha,!
se#a/a ;ha,!- "!#a$.%&a$ "e$*a$ 800 /* !a( ha,! se#a/a 2; /!$**% Te,a(!
be"ah be,%(a as(!,as! "a$ (e$)a#!,a$ Te&$!& as(!,as! "a(a "!#a&%&a$ sea,a b%a-
ea(! seba!&$)a seba*a! %$%$a$ %#,as+$+*,a'! seh!$**a "a(a /e$ a(a!
%%$a$ "e$*a$ e(a As(!,as! "a(a "!#a&%&a$ be,%#a$*%#a$* sea,a e,%%( aa%
"!#a$.%&a$ "e$*a$ (e/asa$*a$ &aee, (e$)a#!, Pa"a se/%a !$"a&a$ ha,%s
"(e,ha!&a$ (,+se"%, ase(!& "a$ a$!se(! %$%& /e$e*ah !$'e&s! se&%$"e,
@a,a as(!,as! /e$*%$%$*&a$ &a,e$a !"a& /e$**a$**% '%$*s! !a# &e$)a/a$a$
(e$"e,!a !"a& /e$)ebab&a$ &+$a/!$as! ,+$**a (e#!+$e%/ "a$ /%,ah As(!,as!
ha,%s "!#a&%&a$ "e$*a$ &aee, )a$* %&%( besa, K+$,a!$"!&as! a"a#ah as!es
"a$ s,%&%, !a# /e$*ha#a$*! .a#a$$)a .a,%/ &+$,+e,s! e$a$* "!#a&%&a$
as(!,as! "!#a$.%&a$ "e$*a$ ",a!$ase aa% %&%( +ba a$!/%ba sa.a Saa !$!-
e,a(! as(!,as! "a(a "!#a&%&a$ (a"a &ea"aa$ &e!&a 314 se,+#+*! a/%ba!"a&
/e$e$%&a$ "!a*$+s!s ba$"!$* %a/a a"a#ah abses ha! (!+*e$!&- 324 (e/be,!a$
a$!a/%ba "!a$**a( &%,a$* e(a (a"a &eha/!#a$ 3;4 "!"%*a e,.a"! !$'e&s!
se&%$"e, (a"a 189 &as%s- 3<4 "e/a/ "a$ $)e,! ea( "!,asa ;8 ha,! (asae,a(!-
"a$ 384 b!#a "!$)aa&a$ e,"a(a baha)a (eah "a$ abses besa, 38/4 B!#a
"!(e,#%&a$- "a(a "!(asa$* ",a!$ (e,&%a$ "e$*a$ ",a!$ase e,%%(C
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Pen$a/i%an (e/a/,i La'a!.+.mi" Pe$)a#!,a$ e,b%&a "!#a&%&a$ b!#a
(e$*+baa$ *a*a# "e$*a$ e,a(! &+$se,a!'- e,/as%& as(#,as! be,%#a$* I$"!&as!
#a!$ a"a#ah abses ha! #+b%s &!,! )a$* e,a$a/ (eah &e ,+$**a (e,!+$e%/ "a$
&e +,*a$ #a!$ e,/as%& &e "!$"!$* (e,%- "a$ !$'e&s! se&%$"e, )a$* !"a&
e,&e$"a#! A$*&a &e/a!a$ "e$*a$ a,a !$! #eb!h !$**! !&a !$"a&a$ #a(a,++/!
"!b%%h&a$- /a&a "!#a&%&a$ "e$*a$ sa)aa$ s%b&+sa# &a$a$ Abses "!b%&a-
"!#a&%&a$ (e$)a#!,a$- "!%! "e$*a$ #a,%a$ *a,a/ '!s!+#+*!& "a$ #a,%a$
a$!b!+!& se,a "e$*a$ %#,as+$+*,a'! !$,a+(e,a!' C
KO(PL)KAS)
Ab#e# He'a! Am.eba
K+/(#!&as! )a$* (a#!$* se,!$* a"a#ah ,%(%, abses sebesa, 8 8-6 9
R%(%, "a(a e,.a"! &e (#e%,a- (a,%- (e,!&a,"!%/- %s%s- !$,a(e,!+$ea# aa%
&%#! Ka"a$*&a"a$* "a(a e,.a"! s%(e,!$'e&s!- e,%a/a see#ah as(!,as! aa%
",a!$ase I$'e&s! (#e%,+($e%/+$a# a"a#ah &+/(#!&as! )a$* (a#!$* %/%/
e,.a"! Me&a$!s/e !$'e&s! e,/as%& (e$*e/ba$*a$ e'%s! se,+sa s!/(a!&-
(eah$)a abses ha! &e "a#a/ ,+$**a "a"a )a$* "a(a /e$)ebab&a$
e/(!e/a- se,a (e$)eba,a$ he/a+*e$ seh!$**a e,.a"! !$'e&s! (a,e$&!/
F!s%#a he(a+b,+$&!a# "a(a /e$)ebab&a$ ba%& (,+"%&!' "e$*a$ baha$
$e&,+!& /e$*a$"%$* a/+eba F!s%#a b,+$&+(#e%,a# /%$*&!$ .a,a$* e,.a"!
K+/(#!&as! (a"a .a$%$* b!asa$)a "!&a!&a$ (eah$)a abses (a"a #+b%s &!,!
ha! "!/a$a !$! "a(a /e$!/b%#&a$ &e/a!a$ Peah aa% ,%(%,$)a abses
"a(a &e +,*a$+,*a$ (e,!+$!%/ "a$ /e"!as!$%/ Kas%s (se%"+a$e%,)s/
a,e,! he(a!&a e#ah "!#a(+,&a$ e,.a"! seba*a! &+/(#!&as! 6
Ab#e# He'a! Pi.geni-
Saa "!a*$+s!s "!e*a&&a$- /e$**a/ba,&a$ &ea"aa$ (e$)a&! be,a se(e,!
se(!&a/!a5ba&e,!/!a "e$*a$ /+,a#!as 89- ,%(%, abses ha! "!se,a!
(e,!+$!!s *e$e,a#!saa "e$*a$ /+,a#!as 6C9- &e#a!$a$ (#e%,+(%#/+$a#-
*a*a# ha!- (e,"a,aha$ &e "a#a/ ,+$**a abses- he/+b!#!a- e/(!e/a- '!s%#a
he(a+b,+$&!a#- ,%(%, &e "a#a/ (e,!&a," aa% ,e,+(e,!$e%/ Ses%"ah
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/e$"a(a&a$ e,a(!- se,!$* e,.a"! "!aes!s he/+,a*!&- !$'e&s! #%&a- abses
,e&%,e$- (e,"a,aha$ se&%$"e, "a$ e,.a"! ,e&%,e$s! aa% ,ea&!'as! abses 2
PRO*NOS)S
Pa"a &as%s AHA- se.a& "!*%$a&a$ +ba se(e,! "eh!",+e/e!$ aa% e/e!$-
/e,+$!"a7+#e "a$ &#+,+%!$- /+,a#!as /e$%,%$ a.a/ M+,a#!as "! ,%/ah
sa&! "e$*a$ 'as!#!as /e$%,%$ a.a/ M+,a#!as "! ,%/ah sa&! "e$*a$
'as!#!as /e/a"a! se&!a, 29 "a$ (a"a 'as!#!as )a$* &%,a$* /e/a"a!
/+,a#!as$)a 109 Pa"a &as%s )a$* /e/b%%h&a$ !$"a&a$ +(e,as!/+,a#!as se&!a, 129 !&a a"a (e,!+$!!s a/%ba- /+,a#!as "a(a /e$a(a!
<0809 Ke/a!a$ )a$* !$**! !$! "!sebab&a$ &ea"aa$ %/%/ )a$* .e#e&-
/a#$%,!s!- !&e,%s- "a$ ,e$.aa$ Sebab &e/a!a$ b!asa$)a se(s!s aa% s!$",+/
he(a+,e$a# Se#a!$ !%- (,+*$+s!s (e$)a&! !$! .%*a "!(e$*a,%h! +#eh !,%#e$s!
(e$)a&!- sa%s !/%$!as- %s!a #a$.%- #ea& se,a .%/#ah abses "a$ e,"a(a$)a
&+/(#!&as! Ke/a!a$ e,.a"! (a"a se&!a, 89 (as!e$ "e$*a$ !$'e&s!
e&,a!$es!$a#- se,a !$'e&s! (e,!+$!a# "a$ (e,!&a,"!%/ 2
P,+*$+s!s abses (!+*e$!& sa$*a "!e$%&a$ "!a*$+s!s "!$!- #+&as! )a$*
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DAFTAR PUSTAKA
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Pe$e,b!a$ De(a,e/e$ I#/% Pe$)a&! Da#a/ Fa&%#as Ke"+&e,a$
U$!e,s!as I$"+$es!a 2010 Ha# <60<61
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Da#a/ : P,!e- S)#!a A W!#s+$- L+,,a!$e M Pa+'!s!+#+*! &+$se( &#!$!s
(,+ses(,+ses (e$)a&! +#1 e"!s! 6 a&a,a : E=@ 2006 Ha# <C2<C6
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< S.a/s%h!"a.a-R "e+$*- W!/ B%&% A.a, I#/% Be"ah a&a,a : E=@
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