Peritonitis Difus e.c. App Perforasi)

8/18/2019 Peritonitis Difus e.c. App Perforasi)

1/11

LAPORAN KASUS

Peritonitis Difus

STASE ILMU BEDAH

RSUD CIANJUR

DISUSUN OLEH

Rahmi Dwi Winarsih 2010730087

Pembimbing: r! H! Li"i #! D$%ewaen&' S(!)

PROGRAM STUDI PENDIDIKAN DOKTER

FAKULTAS KEDOKTERAN DAN KESEHATAN

UNIVERSITAS MUHAMMADIAH JAKARTA

!"#$

L%&or%n K %sus


2/11

IDENTITAS PASIEN

Nama : *n! D

Usia : 17 *ah+n

S,a,+s : )e"+m meni-ah

."ama, : #(! Le+we+ng #%ne' #e/! iran$ar

*g"! RS : 0 +"i 2014

*g"! Pemeri-saan : 0 +"i 2014

AUTOANAMNESIS

Ke'u(%n Ut%)%*

N&eri (er+, -ese"+r+han s+ah 3 hari!

Ri+%,%t Pen,%-it Se-%r%n.*

Os a,ang -e I5D RSUD ian$+r menge"+h n&eri (er+, -ese"+r+han s+ah 3 hari! 6

hari &ang "a"+ %s merasa-an n&eri i +"+ ha,i "a"+ -e (er+, -anan bawah iser,ai m+a" 9'

m+n,ah 6;hr 9' na


3/11

Sebe"+m n&eri (er+, &ang irasa-an se-arang' %s menga-+ sering ma-an ma-anan

&ang (eas! Os menga-+ ,ia- mer%-%- an meng%ns+msi a"-%h%"!

PEMERIKSAAN FISIK

#0 Ke%1%%n U)u)

#eaaan +m+m : ,am(a- sa-i, seang

#esaaran : /%m(%s men,is

!0 T%n1% Vit%'

*D : 120;80 mmHg

Nai : 80;meni,

RR : 20;meni,

S+h+ : 37'8>

20 St%tus Gener%'is%t%

#e(a"a ?n%rm%/e(ha"' ramb+, warna hi,am' r%n,%- =9@

= a,a : -%n$+ng,iAa anemis =;=9' s-"era i-,eri- =;=9= Hi+ng : ,ia- ,am(a- aan&a e


4/11

+

+

+

+

+

+

+

+

+

Pa"(asi : n&eri ,e-an 9' e


5/11

S,a,+s "%-a"is e;r ab%men ia(a,-an aan&a is,ensi ab%men' bising +s+s men+r+n

4;mn,' n&eri ,e-an an e


6/11

Wa"a+(+n a(enisi,is a(a, ,er$ai (aa se,ia( +sia' nam+n (a"ing sering ,er$ai (aa

rema$a an ewasa m+a' ang-a m%r,a"i,as (en&a-i, ini ,inggi sebe"+m era an,ibi%,i-!

B0 An%to)i

.b%men aa"ah r%ngga ,erbesar a"am ,+b+h! Dining (er+, mengan+ng

s,r+-,+r m+s-+"% a(%ne+r%sis &ang -%m("e-s! Dibagian be"a-ang' s,r+-,+r ini me"e-a,

(aa ,+"ang be"a-ang' i sebe"ah a,as (aa iga' an i bagian bawah me"e-a, (aa ,+"ang

(angg+"! Dining (er+, ,eriri a,as bebera(a "a(is' &ai,+ ari "+ar -e a"am' "a(isan -+"i,

&ang ,eriri ari:

1! #+,is!

2! S+b-+,is!

= as/ia s+(er


7/11

L+mbaris sinis,ra' regi% sebe"ah -iri +mbi"i-a"is: In,es,in+m ,en+e' %"%n es/enens

Ing+ina"is;I"ia/a e,ra' regi% -anan bawah: ae/+m' .((eni Aermi


8/11

Disebab-an %"eh inAasi ba-,eri hema,%gen ari %rgan (eri,%nea" a,a+

m%n%mi-r%bia"! Pen&ebab (a"ing sering (eri,%ni,is (rimer aa"ah s(%n,ane%+s

ba/,eria" (eri,%ni,is a-iba, (en&a-i, he(ar -r%nis! #ira= -ira 10=30 (asien engan

sir%sis he(a,is engan asi/,es a-an ber-embang men$ai (eri,%ni,is ba/,eria"!

2! Peri,%ni,is se-+ner

Pen&ebab (eri,%ni,is se-+ner (%"im%n%ba-,eria"! Sering ,er$ai (aa

a((eni/i,is' (er


9/11

+s+s &ang meregang an a(a, menggangg+ (+"ihn&a (ergera-an +s+s an

menga-iba,-an %bs,r+-si +s+s!

Paa a(enisi,is isebab-an %"eh (en&+mba,an "+men a(eni-s %"eh


10/11

Paa (eneri,a i,em+-an ge$a"a an%re-sia' m+a"' m+n,ah! Peneri,a ii-+,i

baan ,erasa emam an mengigi" hi"ang ,imb+"! ening-a,n&a s+h+ ,+b+h a(a,

men/a(ai 38> sam(ai 40>!

4! a/ies hi(%/ra,esPaa (eri,%ni,is bera, a(a, i,em+-an


11/11

*era(i an,ibi%,i-a har+s iberi-an sesegera se,e"ah iagn%sis (eri,%ni,is ba-,eri

i,ega--an! .n,ibi%,i- bers(e-,r+m "+as iberi-an se/ara em(iri-' an -em+ian ir+bah

$enisn&a se,e"ah hasi" -+",+r -e"+ar! Pi"ihan an,ibi%,i-a iasar-an (aa %rganisme mana

&ang i/+rigai men$ai (en&ebab! .n,ibi%,i-a bers(e-,r+m "+as $+ga mer+(a-an

,ambahan rainase beah! Har+s ,erseia %sis &ang /+-+( (aa saa, (embeahan'

-arena ba-,eremia a-an ber-embang se"ama %(erasi!

Pena,a"a-sanaan (eri,%ni,is se/ara -a+sa" ia"ah erai-asi -+man &ang

men&ebab-an raang i (eri,%ne+m! Se/ara n%n=inAasi< a(a, i"a-+-an engan rainase

abses an en%s-%(i (er-+,an' nam+n &ang "ebih +m+m i"a-+-an ia"ah "a(ar%,%mi

e-s("%rasi r%ngga (eri,%ne+m!

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Peritonitis Difus e.c. App Perforasi)