LAPJAG 16 APRIL DEVINA.pptx

7/26/2019 LAPJAG 16 APRIL DEVINA.pptx

1/18

LAPORAN JAGA16 APRIL 2016


2/18

KASUS 1


3/18

IDENTITAS

Nama : Ny. LM

Usia : 28 t

A!am!"sa #i$a%&%a! s"'a(a a&t)a!am!"sa #a!

a$$)a!am!"sa #"!*a! i+& ,asi"! #i -a!*sa$

RSUS ,&%&$ 18.00 I- ,a#a ta!**a$ 16 A,(i$

2016.


4/18

ANAMNESA

KU : Ny"(i ,a#a s"$&(& $a,a!* ,"(&t s"/a% 6 /am SMRS 1

A,(i$ 2016.

RPS : Ny"(i ,"(&t ,a#a s"$&(& $a,a!* a+#)m"! s"/a% 6 /am

SMRS3 #i(asa%a! m"!#a#a%3 t"(&s m"!"(&s3 #a! s"ma%i!

+"(at t"(&tama saat +"(*"(a%. M&a$ 4 m&!ta 4 s"+a!ya%

510 ,"( a(i +"(isi 'ai(a! #a! s"m,at +"(7a(!a i/a&. Ti#a%

#a,at ma%a!3 +&a!* a!*i! 3 -A- s"/a% 1 A,(i$ 2016.

-AK 4 s"#i%it. D"mam 4 s"/a% 2 a(i SMRS. P"!&(&!a!+"(at +a#a! 3 ti#a% a#a (i7ayat -A- +"(#a(a ata& itam.

Ri7ayat a$"(*i 3 ),"(asi S9 1 ta&! 201.


5/18

PEMERIKSAAN ;ISIK

K"a#aa! &m&m : tam,a% sa%it +"(at

K"sa#a(a! : ')m,)s m"!tis

Ta!#a < ta!#a =ita$ :

TD : 160>?0 mm@*

Na#i : 11>m"!it

RR : 12>m"!it

S&& : 6.?)9


6/18

STATUS GENERALIS

K",a$a : #+!

Mata : is)%)(3 mm>mm. R9 4>43 9A>3 SI >

Ja!t&!* : S1S2 ("*&$"(

Pa(& : B"s 4>4

E%st("mitas : a%(a$ a!*at3 9RT C2 #"ti%.


7/18

STATUS GENERALIS

A+#)m"!

I!s,"%si : 9"m+&!*

A&s%&$tasi : -U

Pa$,asi : S&,"$. Ny"(i t"%a! ,a#a s"$&(& ("*i)

a+#)m"!

P"(%&si : Tim,a!i


8/18

LA-ORATORIUM

Result Reference Range

Full Blood Count

@"m)*$)+i! 1.00 11.01.0

@"mat)'(it 8.?0 .00.00

E(yt()'yt" .6106 .80.20

it" +$))# '"$$ 11.1010 @ .6011.00

P$at"$"t ')&!t 1.00 10.000.00

ESR 1

SGOT 1SGPT 22

Ami$as"

Li,as" 2?


9/18

Result Reference Range

Diff Count

-as),i$ 0

E)si!),i$ 0

-a!# N"&t(),i$

S"*m"!t N"&t(),i$ 8 @

Lym,)'yt" ?

M)!)'yt"

Electrolyte

Na 1? 11

K .1 .6.09$ ?? ?810

U("&m 2

9("ati!i!" 0.6

G;R 12.1


10/18

T@ORA

K"sa! :

9)( #a! ,&$m) ti#a%

tam,a% %"$ai!a!


11/18

9T S9AN @OLE A-DOMEN 9ONTRAST

K"sa! :

- I!=a*i!asi "!t"()"!t"(i' /"/&!)i$"&m s",a!/a!* 4>

'm #"!*a! !)#&$!)#&$ ya!* m"!y"!*at %)!t(as

#i#a$am!ya #iam"t"( 4> 0.81 < 1.12 'm3 '&(i*a #is"(tai

,)$i, #i#a$am!ya.- P"m+"sa(a! (i!*a! KG- m"s"!t"(i&m a+#)m"! %i(i

atas #iam"t"( 4> 1 'm-

O(*a!)(*a! i!t(aa+#)mi!a$ $ai!!ya #a$am +atas!)(ma$.


12/18

DIAGNOSIS

P"(it)!itis DiF&s "' P"(F)(asi J"/&!&m "'

I!=a*i!asi J"/&!&m


13/18

TATA LAKSANA

R> La,a()t)mi E%s,$)(asi 4 R"s"%si Us&s s>#

St)ma


14/18

P"(sia,a! O,"(asi

1. P()s"#&( aa!tis",ti% #a"(a ),"(asi #a! s"%ita(!ya.

2. I!sisi m"#ia!a s&,(ai!F(a&m+i$i%a$ #i,"(#a$am sam,ai ,"(it)!"&m.

. P"(it)!"&m #i+&%a3 #it"m&%a! :

E!t"(i' ')!t"!t +"('am,&( ,&s 4> 00 '' ,a#a s"$&(& ()!**a a+#)m"!. Dist"!si /"/&!&m3 i!=a*i!asi /"/&!&m s",a!/a!* 4> 0 'm3 /a(a% 0 'm #ista$ #a(i t(aits $i*am"!

5 #i$a%&%a! mi$%i!*3 t"(+"+as 4> 10 'm3 #i#a,at%a! +a*ia! ya!* st"!)sis #a! m"!*a$ami,"(F)(asi t",i !"%()ti%.

;i+(i! ya!* masi ma #i$",as%a! #is"%ita( i!=a*i!asi.

M&$ti,$" KG- m"s"!t"(i&m 5 +i),si.

O(*a! s)$i# #a! )$$)7 =is'&s $ai! i!ta%.

. Di,&t&s%a! #i$a%&%a! ("s"%si /"/&!&m 0 'm #ista$ t(aits s",a!/a!* 4> 0 'm

5 /"/&!)st)my.. Di+&at i!sisi /"/&!)st)my F""#i!* t&+" 0 'm #ista$ /"/&!)st)my #"!*a!

'at"t"( si$i')!.

6. Pasa!* #(ai! NGT %" ,"$=is3 '&'i ()!**a a+#)m"!3 (a7at ,"(#a(aa!.

. Di!#i!* a+#)m"! #i/ait $a,is #"mi $a,is.

8. O,"(asi s"$"sai.


15/18

TEMUAN OPERASI

Dit"m&%a! :

E!t"(i' ')!t"!t +"('am,&( ,&s 4> 00 '' ,a#a

s"$&(& ()!**a a+#)m"!.Dist"!si /"/&!&m3 i!=a*i!asi /"/&!&m s",a!/a!* 4> 0

'm3 /a(a% 0 'm #ista$ #a(i t(aits $i*am"! 5 #i$a%&%a!

mi$%i!*3 t"(+"+as 4> 10 'm3 #i#a,at%a! +a*ia! ya!*

st"!)sis #a! m"!*a$ami ,"(F)(asi t",i !"%()ti%.;i+(i! ya!* masi ma #i$",as%a! #is"%ita(

i!=a*i!asi.

M&$ti,$" KG- m"s"!t"(i&m 5 +i),si.


16/18


17/18

Tata$a%sa!a P)st O,

Ra7at I9U

S"m"!ta(a ,&asa3 !&t(isi %" /"/&!)st)my F""#i!* m&$ai

s"t"$a "m)#i!ami% !)(ma$.

I!/"%si 9"Ft(ia)!" 2*(

I!/"%si M"t()!i#aH)$" 00m*


18/18

TERIMA KASI@

LAPJAG 16 APRIL DEVINA.pptx

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