7/21/2019 adenocarsinoma colorecatal
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ADENOCARCINOADENOCARCINO
MAMA
COLORECTALCOLORECTAL
oleholeh
Dr. H. Rivai Ismail, SpBDr. H. Rivai Ismail, SpB
7/21/2019 adenocarsinoma colorecatal
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SigmoidSigmoid
RectumRectum
CaecumCaecum
TransversumTransversum
DesendenDesenden
AscendenAscenden
Lokasi
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EtiologiEtiologi risk aktor risk aktor
Diet tinggi lemak rendah seratDiet tinggi lemak rendah serat
Ri!a"at keluargaRi!a"at keluarga #$% &#$% & Aktivitas isik "g kurangAktivitas isik "g kurang
'(esitas'(esitas
Inlamasi (o!el diseaseInlamasi (o!el disease
$ )lserative colitis$ )lserative colitis
$ Crohn,s disease$ Crohn,s disease
*enetik*enetik
$ +amilier pol"ps colon$ +amilier pol"ps colon
$ Adenoma pol"p$ Adenoma pol"p
)retro sigmoidostom")retro sigmoidostom"
7/21/2019 adenocarsinoma colorecatal
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atologiatologi
-akroskopik -akroskopik
- +ungaing+ungaing
- )lserative)lserative
-ikroskopik -ikroskopik
- AdenocarsinomaAdenocarsinoma- -ucoid carsinoma-ucoid carsinoma
- Signet ring carsinomaSignet ring carsinoma
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Tanda dan ge/alaTanda dan ge/ala
0eluhan chronik 123$45670eluhan chronik 123$4567
Acute on chronik 18$3867Acute on chronik 18$3867
Acute perorasiAcute perorasi
Chronik Chronik Bleeding occultBleeding occult
-aroon-aroon
gelapgelap HitamHitam
merah terangmerah terang
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eru(ahan pola BABeru(ahan pola BAB
DiareDiare
0onstipasi0onstipasi
9"eri o(struksi partial9"eri o(struksi partial
Bentuk eses kecil, pipih:pitaBentuk eses kecil, pipih:pita
0olon kanan mucus0olon kanan mucus
Rectum tenesmusRectum tenesmus
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0eluhan lain0eluhan lain
BB ;BB ;
9asu makan (erkurang9asu makan (erkurangDemamDemam
-assa-assa
'(struksi akut'(struksi akut ileusileuserorasi 1 tu caecumerorasi 1 tu caecum
+istula (uli$(uli+istula (uli$(uli
)terus)terus
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Diagnose
Klinis
Radiologis endoscopi
Laboratorium
Rectal toucher rectum
patologis
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RADIOLOGI
Foto polos abdomen
Barium enema (double kontras
!t scanning"RI
#$G rektum (%R#$%
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&ndoscopi
$igmoidoscop'
!olonoscop'
Biopsi Labor
Darah rutin
Faal hepar FOB% kolon kanan
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atologi ) diagnose pasti
"etastase ) langsung Inplantasi
*ematogen +,porta-hati
Limogen +ircho. node
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$tadium berdasarkan duke
Dukes ADukes A Terbatas Di mukosaTerbatas Di mukosa
Dukes BDukes B Menembus MuskularisMenembus Muskularis
mukosamukosa
Dukes CDukes C
C 1C 1
C 2C 2
Meta KGBMeta KGB
KGB dkt tKGB dkt tuummoor Pr r Pr imer imer
KGB JauhKGB Jauh
Dukes DDukes D Metastase JauhMetastase Jauh
Hepar,Hepar, paru, paru, in!alin!al
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terapi
Obstruksi ) colostomi
#ntuk colon kiri
Kolon kanan
reseksi anastomose/on obstruksi
Reseksi 0 anastomose
Rektum ) anterior reseksi
Lo. anterior reseksi
"iles,,,,,,,,,,,,,,
7/21/2019 adenocarsinoma colorecatal
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ad1u+ant
Kemoterapi ) 2F# 0 Leuco+erin
Radiasi
!olostom'
%emporer
ermanenLoop colostomi
Double barrel colostomi