lapsus - acute appendicitis

8/17/2019 LAPSUS - Acute Appendicitis

1/23

ACUTEAPPENDICITIS

SURYANINGTYASPRABOWO


2/23

Identifkasi• Nama : Ny. F

• Jenis Kelamin : Perem!an

• Usia : "# $a%!n• Ke&an'saan : In()nesia

• A'ama : Islam

• Pe*er+aan : I&! R!ma% Tan''a• Alama$ :

• Tan''al Peri*sa :


3/23

Anamnesis

• Kel!%an U$ama : Nyeri er!$ *anan &a,a%


4/23

Ri,aya$ Per+alanan Penya*i$• Nyeri er!$ *anan &a,a% se+a* - %ari yan' lal!.

• A,alnya nyeri (irasa*an (i !l! %a$i lal! &erin(a% *e

er!$ *anan &a,a%. Nyeri $erasa sema*in %e&a$ se+a* %ari ini.

• Demam a(a se+a* " %ari yan' lal!/ $i(a* $in''i/ $i(a*men''i'il/ $i(a* $er!s mener!s/ (an $i(a* &er*erin'a$.

• Na0s! ma*an &er*!ran' semen+a* sa*i$.• 1!al $i(a* a(a/ m!n$a% $i(a* a(a.

• Ri,aya$ sa*i$ maa' $i(a* a(a.

• BAB $i(a* a(a se+a* - %ari yan' lal!.

• BAK $i(a* a(a *elainan.


5/23

• Ri,aya$ Penya*i$ Da%!l!:

Ri,aya$ enya*i$ (en'an *el!%an yan' sama(isan'*al.


6/23

Pemeriksaan Fisik

• Kea(aan !m!m : $ama* sa*i$ se(an'• Kesa(aran : C1

• Te*anan Dara% : 23#2 mm4'

•Na(i : 5563meni$

• Fre*!ensi Na0as : -- 63 meni$

• S!%! : "5/2 C


7/23

Status Lokalis•Keala : K)n+!n'$i7a al&e&ra !8a$ 939/S*lera i*$eri* 939

•P!il : Is)*)r/ ree*s 8a%aya ;3;

•


8/23

Status Lokalis

Re'i) A&()men

• Inse*si : Da$ar

• Palasi : a(a $i$i*18.B!rney/ nyeri leas =;>

• Per*!si : Tymani

• A!s*!l$asi : Bisin' Us!s =;> 3 N)rmal


9/23

Pemeriksaan Penunjang

Pemeri*saan (ara% r!$in> :

• 4em)'l)&in : "/" 'r3(l

• 4ema$)*ri$ : "5 7)l?

•


10/23

Pemeriksaan Penunjang

• Urinalisa 9 sel ei$el : =;>

9 le!*)si$ : =;>

9 eri$r)si$ : =;>


11/23

Alvarado Score

- Manifestations Value

Symptoms Migration of pain 1

Anorexia -

Nausea/vomiting 1Signs Right Lower Quadrant

Tenderness2

Reound pain 1

!"evated temperature 1

Lab Values Leu#o$%tosis 2

Left &hift -

T'TAL (')NT& 1*


12/23

In$erre$asi Al7ara() S8)re

• : P)ssi&le• # 5 : Pr)&a&le• @ 2 : ery Pr)&a&le

•Pa(a *as!s/ Al7ara() s8)re : 5=Pr)&a&le Aen(isi$is>


13/23

Diagnosis Banding

• Aen(isi$is A*!$

• Pel7i8 Inamma$)ry Disease


14/23

Diagnosis Kerja

• Aen(isi$is A*!$


15/23

Penatalaksanaan

• R!+!* RSA<

• Pr) Aen(i*$)mi


16/23

Follow Up

Selesai (ila*!*an aen(e8$)my emer'en8y (alam

sinal anes$esi $an''al # 1are$ -2. An+!ran )s$) s&&:

•Imm)&ilisasi•Semen$ara !asa

•A,asi S• Ji*a BU=;> &)le% min!m•Ra,a$ &an'sal *elas .-


17/23

erapi :

•IFD NaCl 2/@ ? -5 '$$3i

•In+ Ce0)$a6ime -6 'r I

•In+. Rani$i(in -6 am I•In+. Ke$)r)la8 -6 am (ri


18/23

Follow up! anggal "

#aret $%&' ()ari*awatan I+


19/23

Follow up! anggal &%

#aret $%&' ()ari*awatan III+ ,


20/23

Follow up! anggal &%

#aret $%&' ()ari*awatan III+ ,


21/23

-dukasi ,

•Kea(a asien (an *el!ar'anya (i+elas*an enye&a&$im&!lnya enya*i$ yan' (i(eri$anya (an men+elas*an$in(a*an yan' se%ar!snya (iam&il +i*a an'')$a *el!ar'ayan' lain men'alami 'e+ala9'e+ala a,al aen(isi$is a*!$.

Kontrol ,

• Ti'a %ari se$ela% !lan' (ari r!ma% sa*i$ (i )li &e(a%RSA


22/23

Prognosis

•!) a( 7i$am : &)nam

•!) a( 0!n8$i)nam : &)nam


23/23

TERI1A KASI4

lapsus - acute appendicitis

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