7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 1/32
Oleh : Dr. Akhmad Makhmudi, Sp BAMata kuliah: Ilmu Bedah III (Smt VIII)
Jumat, 31 Desember 2004
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 2/32
ASUS BEDAH ANA
( ONGENITAL)
ILEUS MEGAKOLON
HIGROMA COLLI
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 3/32
A.OMPHALOCELE B. GASTROSCHIZIS
C.TUMOR D. ATRESIA ANI
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 4/32
RESPIRATORY DISTRESS
SYNDROME (RDS)
AA!"MI : Diameter lume#
ke$il, k%sta lebih h%ris%#tal&
th%rak ke$il da# sem'it,
'er#a'asa# abd%mi#al, "2
0 lebih ti#**i+
!ADA DS - !a$h.'#ea,
$.a#%sis, d.s'#ea
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 5/32
AKUT ABDOMEN
I/S
S!A/ASI
I!"I!IS DAAA
5"MBIASI&!AMA
I/S: "B/M5"MSI&DIDASI
DA I65SI
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 6/32
SIMPTOM AND SIGN
SAKIT PERUT
OBSTIPASIKEMBUNG
MUNTAH
ABDOMINAL SIGN
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 7/32
KAUSA SAKIT PERUT
(ABDOMINAL PAIN)
NONORGANIK: EMOSINAL,
KELAINAN SUSUNAN SARAFPUSAT,ORGAN INTRA ABDOMINALNORMAL
ORGANIK: KELAINAN ORGAN
INTRAABDOMINAL DAN DINDINGABDOMEN
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 8/32
SAKIT PERUT-MANIFEST KELAINAN
ORGANIK INTRAPERITONEUM SAKIT KOLIK (COLICKY/
CRAMPING PAIN- SIMPLE
OBSTRUCTION) -
SAKIT TERUS-MENERUS (CONSTANS
PAIN- ISCHEMIC TISSUE)
REFERRED PAIN NERVUS TH X
NYERI RANGSANGAN
PERITONEAL ( DEFANS
MUSCULER)
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 9/32
OBSTRUKSI USUS STRANGULASI-
VOLVULUS EUNUM
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 10/32
APPENDICOGRAM
APPENDICITIS !
GRADE:
I SIMPLEOBSTRUCTION
II SUPPURATIVE
III GANGREN IV RUPTURE
V ABSCES
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 11/32
CECAL ILEUS
RETENSI SISA BARIUM DIDALAM SEKUM
DAN LUMEN APPENDIKS
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 12/32
OBSTRUCTION
DEFINITION: SINDROME GANGGUAN PASASEORGAN BERSALURAN
ORGAN BERSALURAN: ". INTESTINUM
#. DUCTUS BILIARIS
$. DUCTUS PANCREATICUS
%. URINARY TRACT !. TUBA FALLOPII
I L E U S
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 13/32
I L E U S
( INTESTINAL OBSTRUCTION )OBSTRUCTION : YES/ NO
SIMPLE OR STRANGULATION
HIGH OR LO& OBSTRUCTION
PARTIAL OR TOTAL
MECHANIC OR FUNCTIONALSYSTEMIC COMPLICATION
LOCAL COMPLICATION
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 14/32
HIGH GIT OBSTRUCTION
GASTRIC OUTLET OBSTRUCTION
- HPS ( HYPERTROPHIC PYLORIC STENOSIS )
- ANTHRAL &EB - PYLORIC MUCOSA PROLAPS
DUODENAL OBSTRUCTION
- ATRESIA/STENOSIS DUODENUM - PANCREAS ANNULARE
- LADD'S MEMBRANE
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 15/32
MECHANICAL LO&ER GIT
OBSTRUCTION
MECONIUM ILEUS MECONIUM PLUG SYNDROME
NEONATAL SMALL LEFT COLON SYN DROME MALROTATION &ITH VOLVULUS INCARCERATED HERNIA EUNOILEAL ATRESIA
COLONIC ATRESIA INTESTINAL DUPLICATION INTUSSUSCEPTION N E C
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 16/32
FUNCTIONAL LO&ER GIT
OBSTRUCTIONSEPSIS
INTRACRANIAL HEMORRHAGE
HYPOTHYROIDISM
MATERNAL DRUG INGESTION OR
ADDICTION
HYPERMAGNESEMIA
HYPOKALEMIA
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 17/32
THIRDS SPACE SYNDROME
APA PERBEDAAN DAN PERSAMAAN
KASUS GASTRO ENTERITIS DAN ILEUS
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 18/32
PROBLEM ILEUS
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 19/32
PROGNOSIS
ILEUS LETAK TINGGI
ILEUS LETAK RENDAH
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 20/32
GIT HAEMORHAGE
UPPER : MELENA
LO&ER : HEMATOCHEZIA RECTAL BLEEDING
LIGAMENTUM TREITZ LIMITED
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 21/32
TERAPI NUTRISI PARENTERAL
BB AS : 7AIA SSI!ASI /8 ASI
6/"9 AS : 7AIA !ISI 5 : D, D10
"!I : ASAM AMI" 2,, ,10
/MA5 : /IID 20
/5!"/I!: 5A I B, 3A, 3B
MIA/
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 22/32
"AM 7AIA :( JAM )
1+JM/A 7AIA2+JIS 7AIA
3+7AA MBIA
4+M"I!"I
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 23/32
*+ 01 :
1+ De;isit $aira# 8 dehidrasi
a+ Dehidrasi i#*a# : ( 0ml8k*bb < !B9 )
b + Dehidrasi Seda#* : 10 (100ml8k*bb < !B9 )
$+ Dehidrasi Berat : 1 (10ml8kbbb < !B9 )= !%#isitas darah:i'%t%#is,is%t%#is,hi'ert%#is
2+ Mai#te#a#$e
e%#atus: 24 >am '%st %'erati; dikura#*i 30
3+ erkiraa# $aira# hila#* dalam 24 >am( %# *%i#* l%ss )
2?3 m%di;i$ati%# t% 6luid i#take ( see table )
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 24/32
TOTAL BODY WATER ( ASHCRAFT )
M
estasi%#al @ 12 mi#**u 4
12 mi#**u @ 32 mi#**u 0
Aterm
3& hari C
&3 @
e%#atus C &
0
7hildre# &C
%u#* Ma# 0
%u#* 9%ma# 0
"Eer 0 .ears ma# 0"Eer 0 .ears F%me# 4
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 25/32
MAINTENANCE ( ASHCRAFT ) = Dail. 6luid eGuireme#ts
&234 V5+*2
P02*402 (6 #73 ) "!8 *+ / 73
N25149 1;14 (#-"8 73 ) "88*+/73 ;50 ;094 "873
I1;14 +<021 ("8-#873 ) "888*+=!8*+/73 5>20 "8 73
C+<021 ( ? #8 73 ) "!88*+=#8*+/73 5>20 #8 73
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 27/32
I10292
6ull a$tiEit. H %ral ;eeds 1+
6eEer H 12 'er 7
%%m tem'erature 31 7 H 30 'er 7
.'erEe#tilati%# 1+2e%#ate & 'reterm (1&1+ k* ) 1+2
& radia#t heater 1+
& 'h%t% tera'. 1+
Bur# & ;irst da. H 4 'er 1
area bur# & SubseGue#tl. H 2 'er 1
area bur#
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 28/32
NAMA PRODUK OSMOLARITAS N,= C+- K= C,== A924,42 L,4,42- G+)759, K,+50 KEMASAN
*O9*/L K,+/LK,2N " B #@# $@.! $@.! $.! "!8 !88
K,2N $ A #8 8 !8 "8 #8 # "8@ !88
K,2N $ B #8 !8 !8 #8 #8 # "8@ !88
K,2N MG$ ! !8 !8 #8 #8 "88 %88 !88
!88/"888
A92013 #$.% "$8 "8@. % #. #@ !88
KOMPOSISI ELEKTROLIT ( mEq/L )
KOMPOSISI LARUTAN KA EN DAN ASERING
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 29/32
D/940/)4/51 C5*E,0,4/>2 :
K5*E,042*21 U*)0
N251,4)9 C-/+<021 A<)+4
70S lasma : 1 1 2 1
I#tersisil : 3
7IS 1 3 2
Transeluler : 1 % - 3 % BB
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 30/32
AD : a#tidiureti$ h%rm%#e
I : i#termitte#t '%sitiEe 'ressure Ee#tilati%#
INSENSIBLE &ATER LOSS
mur e%#atus 8k*bb8hr mr 8k*bb8hr
dara bebas ta#'a kelembaba# 2 $$ Ba.i (0&0 $$
umidi;ied is%lette 14 $$ A#ak 40 $$
ema#asa# 40 & 4( $$ ,ema>a 30 $$
7/17/2019 Akut Abdomen
http://slidepdf.com/reader/full/akut-abdomen-568f512b5d1bf 31/32
KASUS :
PASIEN BAYI USIA %8 HARI(BB %KG)
DENGAN ILEUS DISERTAI DEHIDRASI
BERAT DAN FEBRIS SUHU %88
C,ASIDOSIS METABOLIK DAN ANEMIA.
HASIL LAB.HB @G, ALBUMIN # G/DL, K=
# ME/L, NA= "8 ME/L, TROMBOSIT
!8888 MM# /DL. TERANGKAN PENATALAKSANAAN
LENGKAP