AKUT ABDOMEN DIVISI BEDAH DIGESTIFBAGIAN ILMU BEDAHFK. UNAIR SURABAYA

AKUT ABDOMEN NON TRAUMATIKAKUT PER AKUTNYERI ABDOMENKEADAAN UMUM 6 JAM SURGERY

DO IT RIGHT FROM THE START

PENYEBAB AKUT ABDOMEN GARIS BESAR

NON SURGICAL (TERMASUK KELAINAN DILUAR ABDOMEN)PERITONITIS LOKAL / GENERALOBSTRUKSI GASTRO INTESTINALPERDARAHAN INTRA / RETROPERITONEALISKEMIA / INFARKUROLOGIS - GINEKOLOGIS

PENYEBAB AKUT ABDOMEN SEGALA USIAANAK-ANAK APENDISITISINVAGINASIPERFORASI USUS/LAMBUNGRADANG SALURAN KEMIHNYERI ABDOMEN NON SPESIFIKHERNIA (NON BEDAH)RADANG SALURAN NAPAS ATASOBSTRUKSI USUSPANKREATITIS AKUTWANITAKOLIK GINJAL/ URETERRADANG PELVISDYSPEPSIARADANG SALURAN KEMIHHERNIAKEHAMILAN EKTOPIKKOLESISTITIS AKUT/BILIERKISTA OVARIUM

USIA TUAKANKERVASKULAR SEBAB-SEBAB MEDIK

WORLD ORGANIZATION OF GASTROENTEROLOGY RESEARCH COMMITTEE ON ACUTE ABDOMINAL PAIN (1979)N%NON SPECIFIC ABDOMINAL PAIN 262343.0ACUTE APPENDICITIS147624.2ACUTE CHOLECYSTITIS5418.9SMALL BOWEL OBSTRUCTION2924.0RENAL COLIC2093.4PERFORATED PEPTIC ULCER1722.8ACUTE PANCREATITIS1382.3ACUTE DIVERTICULAR DISEASE1282.1ALL OTHER CASES 5689.8 (GYNAEC + CA COLON)

TOTAL6097

NYERI ABDOMEN REVERSED PAINNYERI YANG DIALIRKAN KARENA KONFERGENSI SARAF PADA TRAKTUS SPINOTALAMIK (EMBRIOLOGIS)

FORE GUTMID GUTHIND GUT

CAUSES OF HEMOPERITONEUMGASTROINTESTINALTRAUMATIC LACERATION OF LIVER, SPLEEN, PANCREAS, MESENTERY, BOWEL GYNECOLOGICRUPTURED ECTOPIC PREGNANCY RUPTURED GRAAFIAN FOLLICLERUPTURED UTERUSVASCULARRUPTURED ANEURYSM : AORTOILIAC, HEPATIC, RENAL, AND SPLENIC ARTERYUROLOGIC RUPTURED BLADDERHEMATOLOGICRUPTURED SPLEEN

Z. COPE :

MANY EXAMINATION OF THE ABDOMEN ARE IMPERFECT BECAUSE THE PRACTITIONER DOES NOT ACT UPON THE IMPORTANT PRINCIPLE OF APPLYING HIS KNOWLEDGE OF ANATOMY

NYERI KLINISKOLIK: RENAL BILIER INTESTINAL

RADANG : SEPTIK KIMIAWI

ISKEMIA

PROGRES PENYAKITPROSES > GEJALAWAKTU : MIGRATORY PAIN (apendisitis)EMOSI OBJEKTIF > SUBJEKTIFOBAT KOSTIKOSTEROID STEROIDANALGETIKA SPASMOLITIK DIAGNOSA BELUM PASTI JANGAN ANALGETIKA

WANITA 24 TAHUN IBU 2 ANAK KECIL NYERI ABDOMEN 24 JAMMULAI PUSAT SAMPAI ILIAKA KANAN TEGANG RLQ + REBOUND PHEN LEKO 17.000 OPERASI ?

WANITA 18 TAHUN PELAJAR SMUDIBAWA KE RS DENGAN DUGAAN APENDISITIS AKUTKELUHAN NYERI PERUT KANAN BAWAHDEFANS MUSKULER REBOUND PHEN LEKO 7.600 APENDEKTOMI ?

GEJALA KLINIS (PENUNJANG)

MUNTAH NYERI MUNTAH : APENDISITISMUNTAH NYERI : GASTRO ENTERITIS IKTERUS - HEPATOBILIERHEMATURIA UROLOGI OBSTIPASI G I HAID

DIAGNOSADIAGNOSE MUST BE ESTABLISHED IN THE EARLIEST POSSIBLE STAGE

KLINISSOAP

LABORATORIUM - STANDARHb LEKOSIT, HCT,TROMBOSIT FAAL HEMOSTASIS

BIOKIMIA DARAH (INDIKASI) AMYLASEGLUKOSAKREATININFAAL HEPAR

URINELENGKAP

RADIOLOGIABDOMEN POLOS BERBARINGABDOMEN POLOS TEGAK/DEKUBITUSDIAFRAGMATHORAX

ULTRASONOGRAFI

ELEKTRO KARDIOGRAFI

WAKTU OPTIMAL PEMBEDAHAN

TEKANAN VENA SENTRAL STABIL 80 120 mm H2OMINIMAL CAIRAN DEFISIT SUDAH DIGANTI KOREKSI ELEKTROLIT ABNORMAL URINE 30 50 ml/JAMHCT 36%NASOGASTRIC TUBEOBAT-OBAT