Perforasi Usus

Jeanne d’Arc Dyanchana 1310211076

Definisi

Perforasi usus, adalah suatu kondisi medis yang ditandai dengan terbentuknya suatu lubang pada dinding usus halus atau usus besar, yang menyebabkan kebocoran isi usus kedalam rongga perut.

Etiologinya banyak• Trauma tajam abdomen seperti pada luka tusuk oleh pisau.

• Trauma tumpul abdomen luka pukul

• Obat-obatan seperti aspirin, non steroidal anti inflammatory drugs (NSAIDs), dan steroid.

• Adanya penyakit sebelumnya Ulkus peptikum, apendisitis akut, divertikulitis akut

• Infeksi bakteri Infeksi bakteri seperti demam tifoid bisa menyebabkan perforasi usus halus sekitar 5%.

• Perforasi usus halus oleh keganasan intra abdominal.

Manifestasi

Symptoms may include:• Severe abdominal pain• Chills• Fever• Nausea• Vomiting

When peritonitis occurs, the abdomen feels very tender. Pain often worsens when the area is touched or palpated

Diagnosis

To diagnose GP, your healthcare provider will likely:

• take X-rays of your chest or abdomen to check for air in the abdominal cavity

• take a CT scan to look for the location of the hole• order a test for a white blood cell count (WBC). WBC may be

higher than usual indicating inflammation or infection

TreatmentAntibiotics have proven effective in decreasing the rate of postoperative wound infection and in improving outcome in patients with intraperitoneal infection and septicemia.

• Metronidazole (Flagyl) is typically used in combination with an aminoglycoside to provide broad gram-negative and anaerobic coverage.

Dosis : Adult dosing is 7.5 mg/kg IV before surgery. : Pediatric dosing is 15-30 mg/kg/d IV

• Cefoperazone sodium (Cefobid) is a third-generation cephalosporin that inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins

Dosis : Adult dosing is 2-4 g/d IV divided q12h. : Pediatric dosing is 100-150 mg/kg/d IV

Treatment

In most cases, surgery is necessary to close the hole and treat the condition. According to Medscape (MS), the goals of surgery are:• to fix the anatomical problem• to fix the cause of peritonitis• to remove any foreign material in the abdominal cavity that

might cause problems, such as feces, bile, food, etc.

Prognosis• The success of the surgery depends on the size of the

perforation or hole and the length of time before treatment. The chances of recovery improve with an early diagnosis and treatment

Complication

• Complications associated with GP include:• bleeding• sepsis, a life-threatening bacterial infection• abscesses in the belly• wound infection