Ppt Tension Pneumothorax Vina

7/23/2019 Ppt Tension Pneumothorax Vina

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TENSION PNEUMOTHORAX

BAGIAN ILMU BEDAH THORAXFAKULTAS KEDOKTERANUNIVERITAS HASANUDDIN

LAPORAN KASUS

OKTOBER 2015

DIBAWAKAN DALAM RANGKA TUGAS KEPANITERAANKLINIK

PADA BAGIAN ILMU BEDAH FAKULTAS KEDOKTERANUNIVERSITAS HASANUDDIN

MAKASSAR 2015

OLEH:

Delvi! T!"i!#i

SUPERVISOR :

"#$ M%&!''!" N%#!li' M!ll!(!)i*S($B*

S($BTKV


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IDENTITAS PASIEN

Nama : Tn. AJenis Kelamin : LakiLaki

Um!" : #$ %a&!nAlama% : JL. Malin'Rekam Me(ik : )*+,-,Mas!k RS : - Se%em/e" *0#$


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ANAMNESIS

Kel!&an U%ama : Sesak naas Anamnesis Te"imin :

Dialami se1ak 2 1am se/el!m mas!k UGD RS

3a&i(in S!(i"'&!s'(' aki/a% ke4elakaan lal!lin%as

Sesak (i"asakan mem/e"a% (alam # 1am%e"ak&i"

Sesak naas (i"asakan %e"!s mene"!s (an%i(ak (ien5a"!&i 'le& ak%i6%as

Sesak naas 1!5a (ise"%ai n7e"i (a(a

N7e"i (a(a (i"asakan see"%i "asa anas (an

%e"%!s!k%!s!k


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ANAMNESIS

Ti(ak a(a "i8a7a% in5san

Ti(ak a(a "i8a7a% m!al (an m!n%a&

Ti(ak a(a "i8a7a% kesa(a"an men!"!n9asien (i"a8a% (i RS B&a7an5ka"a

se/el!m (i"!1!k ke RS 3a&i(in

S!(i"'&!s'('


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MEKANISME TRAUMA

9asien men5alami ke4elakaan saa%men5en(a"ai m'%'" (an /e"%a/"akan

(en5an en5en(a"a m'%'" (en5anke4ea%an se(an5 (a"i a"a&/e"la8anan se&in55a (a(a asien%e"/en%!" ke"as (en5an s%an5 m'%'"


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PEMERIKSAAN FISIS

PRIMARY SURVEY

Ai"8a7 : lea" B"ea%&in5 : 9e"naasan 20 ; < meni%

T&+#!,)

I)(e,)i :9e"5e"akan &emi%&'"aks kanan%e"%in55al (i/an(in5kan &emi%&'"aks ki"i=%e"(aa% en55!naan '%'% /an%!e"na>asan= sela i5a %i(ak mele/a"=

%e"li&a% 5elem/!n5 (i e"m!kaan k!li%


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P!l(!)i :A(a n7e"i %ekan (an k"ei%asi a(a&emi%&'"a; kanan= %i(ak a(a massa %!m'"=%ak%il >"emi%!s &emi%&'"aks kanan kesan

melema& (i/an(in5 &emi%&'"aks ki"i.Pe#,%)i :Hie"s'n'" a(a &emi%&'"aks kananse%in55i IS I IS IV= /a%as s'n'" ke ekaka(a IS V &emi%&'"aks ki"i.

A%),%l-!)i :B!n7i e"na>asan &emi%&'"akskanan melema& (i/an(in5 &emi%&'"aks ki"i=/!n7i e"na>asan %ie ?esik!le"= %i(ak a(a"'nk&i (an 8&ee@in5

PRIMARY SURVEY


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i"4!la%i'nTekanan Da"a& )0


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SECONDARY SURVEY

Re.i+ +#/i-! "e-#!

Inseksi : Tamak &ema%'ma e"i'"/i%a

9alasi : N7e"i %ekan a(a Re.i+ )%(#!l!vi%l! "e-#! Inseksi : Tamak eksk'"iasi !k!"an

#0;$4m

9alasi : N7e"i %ekan a(a

Re.i+ i#!l!vi%l!#

Inseksi : Tamak !(em

9alasi : Te"a/a em6sema s!/k!%is


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FOTO KLINIS PASIEN


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FOTO KLINIS PASIEN


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Ti"!, -!'(!, +#!,! /#+&+v!)%l!# (!"! &e'i-&+#! ,!! T!'(!, (!#e,i' (!#% ,+l!() T!'(!, +#.! -#!,e! "! 3!-%. -e#"+#+. ,e !#!& 4!. )e&!- T!'(!, /!4!.! #!"i+l%)e (!"! )+- -i))%e

Ke)! : Te)i+ (e%'+-&+#! "e-#! "i)e#-!i ,+l!() (!#%

E')e'! )%/,%-i)


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Pe'e#i,)

!!

H!

)il

Nil!i

+#'!l

WB6 17*

8

+.0 #0.0

RB +=2

,

+.00 -.00

HGB #*=

C

#*.0 #-.0

HT 2C 2).0 +,.0

9LT 2*$ #$0 +00

MV ,, ,0C)

MH *C *)2*

MH 22 2*2-

SGOT 9 2,

SG9T $* +#

GDS #2* ,0#,0

Na%"i!m #2- #2-

#+$

Kali!m +=- 2.$ $.#

Kl'"i(a ### C) ###

U"e!m *- #0 $0

K"ea%inin 0=-$ #=2

T ) + #0

BT 200 # )

9T #*=2 #0 #+

A9TT *-=, ** 20

Pe'e#i,)

!!H!)il

Nil!i

+#'!l


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Dia5n'sa

Te)i+ (e%'+-&+#! "e-#! 9ena%alaksanaan

Ren4ana emasan5an chest tube(an watersealed drainage;WSD< (eks%"a

F'll'8 !

9asien se%!1! !n%!k (ilak!kan emasan5an chest

tube (an water sealed drainage. Se%ela&(ilak!kan emasan5an chest tube (an watersealed drainage %e"li&a% /!//le (an !n(!lasia(a /'%'l ("ain. Saa% ini kea(aan asien 1a!&le/i& /aik= sesak na>as (an n7e"i (a(a m!lai/e"k!"an5.


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TENSIONPNEUMOTHORAX


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DEFINISI


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EPIDEMIOLOGI


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ETIOLOGI

T#!%'!


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PATOGENESIS


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PATOGENESIS


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DIAGNOSIS

A!'e)i) Ri8a7a% en7aki% a"! se/el!mn7a see"%iTB a"!= 99OK (ll

Ri8a7a% %"a!ma se/el!mn7a

Mekanisme %"a!ma


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M!ie)-!)i !=!lM!ie)-!)i !=!l


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DIAGNOSIS

Pe'e#i,)!! Fi)i,

1$ I)(e,)i

Daa% %e"1a(i en4em/!n5an a(a sisi7an5 saki% &ie"eksansi (in(in5 (a(a

9a(a 8ak%! "esi"asi= /a5ian 7an5 saki%

5e"akann7a %e"%in55al T"akea (an 1an%!n5 %e"('"'n5 ke sisi 7an5

se&a%


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2$ P!l(!)i

a. 9a(a sisi 7an5 saki%= "!an5 an%a" i5a (aa%n'"mal a%a! mele/a"

/. Ik%!s 1an%!n5 %e"('"'n5 ke sisi %'"aks 7an5se&a%

4. F"emi%!s s!a"a melema& a%a! men5&ilan5a(a sisi 7an5 saki%

>$ Pe#,%)i(. S!a"a ke%'k a(a sisi saki%= &ie"s'n'"

samai %imani (an %i(ak men55e%a"

e. Ba%as 1an%!n5 %e"('"'n5 ke a"a& %'"aks 7an5

se&a%= aa/ila %ekanan in%"ale!"a %in55i

Pe'e#i,)!! Fi)i,


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?$ A%),%l-!)ia. 9a(a /a5ian 7an5 saki%= s!a"a naas

melema& samai men5&ilan5

/. S!a"a ?'kal melema& (an %i(ak

men55e%a" se"%a /"'nk'>'ni ne5a%i>

Pe'e#i,)!! Fi)i,


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F+-+ R+-.e Ba5ian ne!m'%&'"a; akan %amak l!sen=

"a%a (an a"! 7an5 k'las akan %amak 5a"is

7an5 me"!akan %ei a"!. 9a"! 7an5 men5alami k'las &an7a %amak

see"%i massa "a(i' 'a!e 7an5 /e"a(a (i(ae"a& &il!s. Kea(aan ini men!n1!kkan k'las

a"! 7an5 l!as sekali.Jan%!n5 (an %"akea %e"('"'n5 ke sisi 7an5

se&a%= sa%i!m in%e"4's%als mele/a"=(ia>"a5ma men(a%a" (an %e"%ekan ke /a8a&.

e'e#i,)!! Pe%3!.


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A!li)! G!) D!#!&Analisis 5as (a"a& a"%e"i (aa% mem/e"ikan5am/a"an &i'ksemi

6T@)! -&+#!

Le/i& sesi6k !n%!k mem/e(akan an%a"a em6sema/!ll'sa (en5an ne!m'%&'"a;= /a%as an%a"a !(a"a(en5an 4ai"an in%"a (an eks%"a!lm'ne" (an !n%!kmem/e(akan an%a"a ne!m'%&'"a; s'n%an "ime"

(an sek!n(e". USG

U(a"a (i "'n55a le!"a (i%amilkan an%!lan5el'm/an5 7an5 san5a% %a1am. Ti(ak see"%i !(a"ain%"a!lm'ne"= an%!lan 5el'm/an5 %i(ak /e"5e"aksaa% "esi"asi.

e'e#i,)!! Pe%3!.


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PENATALAKSANAAN

Te"ai se5e"a : Nee(le (e4'm"essi'nTe"ai (e6ni%i> : 9emasan5an 4&es% %!/e

(an water sealed drainageTe"ai lan1!% : T'"ak'%'mi

T'"ak'%'mi me"!akan s!a%! %in(akanem/e(a&an (en5an mem/!ka (in(in5 %'"aksmelal!i 'e"asi. 9em/e(a&an (ilak!kan (en5an

%!1!an men4a"i l!/an5 7an5 men7e/a/kanne!m'%&'"a; kem!(ian (i1a&i%.


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Needle Deco!ression

9"insi : memas!kanka%e%e" ke (alam"'n55a le!"a=se&in55a men7e(iakan

1al!" /a5i !(a"a !n%!kkel!a" (an men5!"an5i%ekanan 7an5 %e"!s/e"%am/a& /isa

(en5an 1a"!m in>!sa%a!3!#%' !//+!-&+$1?

Mengalirkan / drainage udara atau cairan dari rongga pleura untuk mempertahankan tekanan negatif rongga tersebutMengalirkan / drainage udara atau cairan dari rongga pleura untuk mempertahankan tekanan negatif rongga tersebutMengalirkan / drainage udara atau cairan dari rongga pleura untuk mempertahankan tekanan negatif rongga tersebut


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Chest tube "! water sealeddrainage

9"insi : Men5ali"kan

Ppt Tension Pneumothorax Vina

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