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Medika - Jurnal Kedokteran Indonesia - Studi Kasus

Edisi No 08 Vol XLI - 2015 - Studi Kasus

Nyeri Epigastrik sebagai Gejala Ruptur Hati pada Sirosis Hepatis dengan Hepatitis B Kronik

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Winson Jos

Dokter Internship RSUD Tarakan,

Kota Tarakan, Kalimantan Utara

 

Pendahuluan

Nyeri perut dapat bersifat ringan atau mengancam nyawa. Kondisi nyeri peru­t hebat dengan onset mendadak (kurang dari 24 jam) yang membutuhkan penanganan segera dikenal dengan sebutan nyeri abdomen akut.1 Nyeri abdomen akut merupakan masalah yang sering dihadapi di Instalasi Gawat Darurat dengan jumlah kasus mencapai 9,6% dari seluruh kasus kegawatdaruratan bedah.2 Kasus ruptur hati non-trau­matik jarang terjadi dan bersifat menganca­m nyawa.3
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Edisi No 08 Vol XLI - 2015 - Studi Kasus

Luka Tembak di Kepala Pada Anak akibat Senapan Angin

 

FARID YUDOYONO, MIRNA SOBANA, FIRMAN PRIGUNA TJAHJONO, RULLY HANAFI DAHLAN, MUHAMMAD ZAFRULLAH ARIFIN

 

Departemen Ilmu Bedah Saraf, Rumah Sakit Hasan Sadikin, Fakultas Kedokteran, Universitas Padjadjaran, Bandung,

Jawa Barat.

Pendahuluan

Berdasarkan data USPCPS (United State Consumer Product Safety Commission) pada tahun 1990 – 2000 terdapat 3,2 juta senapan angin dijual tiap tahun di Amerika Serikat. Insidensi luka tembak disebab­kan oleh senapan angin adalah 7,71 per 100.000 populasi. Dilaporkan juga terjad­i 39 kematian yang disebabkan oleh senapan angin dan 32 orang di antaranya adalah anak di bawah umur 15 tahun.1,2,3,4,5

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Edisi No 07 Vol XLI - 2015 - Studi Kasus

Hiperplasia Adrenal Kongenital

 

ANIK WIDIJANTI,

SHERLY INTANWATI

 

Laboratorium Patologi Klinik RSU Dr. Saiful Anwar/FKUB Malang

 

Pendahuluan

Hiperplasia adrenal kongenital (HAK) merupakan kelainan bawaan auto­som­al resesif di mana  terjadi defisiensi salah satu dari kelima enzim yang dibutuh­kan untuk sintesis kortisol di korteks adrenal. Terganggunya sekresi kortisol menyebabkan hipersekresi corticotrophin-releasing hormone (CRH) dan adrenocorticotropic hormone (ACTH) yang pada akhirnya menyebabkan hiperplasia kelenjar adrenal. Insidensi HAK berkisar antara 1:10.000 hingga 1:20.000 kelahi­ran. Defisiensi enzim 21-hidroksilase (21-OH) merupakan bentuk HAK tersering yang terjadi pada 90-95% kasus HAK.1-4 Hiperplasia adrenal kongenital memiliki spektru­m fetoptip yang sangat luas. Pada HAK tipe klasik, gejala akan tampak pada awal kehidupan dan dibedakan menjadi bentu­k virilisasi sederhana dan bentuk salt-wasting yang memiliki gambaran klinis lebih berat. Tipe HAK non-klasik yang biasanya lebih ringan akan mulai bermanifestasi di usia yang lebih tua dengan derajat virilisasi dan infertilitas yang bervariasi pada pasien wanita.3

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