Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

3

Share

Download to read offline

INTESTINAL OBSTRUCTION

Download to read offline

Pengenalan asas mengenai INTESTINAL OBSTRUCTION

Related Books

Free with a 30 day trial from Scribd

See all

Related Audiobooks

Free with a 30 day trial from Scribd

See all

INTESTINAL OBSTRUCTION

  1. 1. INTESTINAL OBSTRUCTION Disediakan Oleh : Nassruto
  2. 2. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION DEFINISIDEFINISI Halangan pada pergerakan kehadapanHalangan pada pergerakan kehadapan (forward passage) makanan, najis dan flatus.(forward passage) makanan, najis dan flatus. KLASIFIKASIKLASIFIKASI • Akut : Kronik • Tinggi: Rendah • Partial: Complete • Simple: Strangulated • Mekanikal : Functional (Dynamic) (Adynamic)
  3. 3. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION ETIOLOGIETIOLOGI (according to age(according to age)) Neonates Inperforated anus Volvulus Neonatarum Congenital Atresia Meconium ileus Hirschprungs disease Children Pyloric Stenosis Intussusception Parasites Foreign Bodies
  4. 4. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION ETIOLOGIETIOLOGI (according to age(according to age)) Young & Middle Aged adults Post-op adhesion/bands Strangulated hernia Paralytic ileus Gallstones Elderly Impacted faeces Strangulated hernia Ca. Colon Volvulus Paralytic ileus
  5. 5. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION ETIOLOGIETIOLOGI (according to site(according to site)) Intra Luminal Impacted faeces Parasites worms Meconium ileus Gallstones Foreign bodies Neoplasm Intra Mural Congenital Atresia Tumours Strictures Diverticulitis
  6. 6. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION ETIOLOGIETIOLOGI (according to site(according to site)) MEKANIKALMEKANIKAL Extra Luminal Hernia Bands, adhesions Volvulus Intussusception FUNCTIONAL • Paralytic ileus • Vascular occlusion
  7. 7. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION PATOFISIOLOGIPATOFISIOLOGI Proximal dari halanganProximal dari halangan • Gut Kembong – cecair, makanan dan udara • Konstraksi berlebihan • Reversed peristalsis • Regurgitasi • Kurang penyerapan, gangguan cecair dan electrolite • Dehidrasi dan hipovolumia
  8. 8. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION PATOFISIOLOGIPATOFISIOLOGI Di tempat halanganDi tempat halangan • Bekalan darah berkurangan • Nikrosis • Ulser mukosa • Perforasi • Peritonitis
  9. 9. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION PATOFISIOLOGIPATOFISIOLOGI Distal dari halanganDistal dari halangan • Constipation • Cirit-birit jika incomplete
  10. 10. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION MANIFESTASI KLINIKALMANIFESTASI KLINIKAL 1.1. KardinalKardinal • Sakit abdomenSakit abdomen • MuntahMuntah • Distensi abdomenDistensi abdomen • Constipasi/cirit-biritConstipasi/cirit-birit 2.2. Sakit AbdomenSakit Abdomen • Tiba-tiba, koliki/intermittentTiba-tiba, koliki/intermittent • Setempat di periumbilikalSetempat di periumbilikal • Radiating ke belakangRadiating ke belakang • Berterusan, gangreneBerterusan, gangrene
  11. 11. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION MANIFESTASI KLINIKALMANIFESTASI KLINIKAL 3. Muntah3. Muntah • Teruk, kerapTeruk, kerap • Awal-ada halanganAwal-ada halangan • Lewat-halangan bawahLewat-halangan bawah 4. Distensi abdomen4. Distensi abdomen • Kurang- halangan atasKurang- halangan atas • Nyata – halangan bawahNyata – halangan bawah
  12. 12. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION PEMERIKSAAN FIZIKALPEMERIKSAAN FIZIKAL 1. Inspeksi1. Inspeksi • DistensiDistensi • PeristalsisPeristalsis • Hernial protrusionHernial protrusion • Surgical scarSurgical scar 2. Auscultasi2. Auscultasi • Bowel soundsBowel sounds • Hiperactive/tinklingHiperactive/tinkling • Tiada – paralytic ileusTiada – paralytic ileus
  13. 13. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION PEMERIKSAAN FIZIKALPEMERIKSAAN FIZIKAL 3. Palpasi3. Palpasi • Mass berbentuk sausage – intussusceptionMass berbentuk sausage – intussusception • Segment bowel kembong – halangan close-loopSegment bowel kembong – halangan close-loop • Tanderness – direct/reboundTanderness – direct/rebound • Guarding & Rigidity - peritonitisGuarding & Rigidity - peritonitis 4. Perkusi4. Perkusi • TimpanikTimpanik 5. Per-Rectal (Digital) Mengenalpasti – Intussuception, pelvic mass, ca. rectal
  14. 14. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION INVESTIGASIINVESTIGASI • Darah : Hb%, TWDC, BUSE, GXMDarah : Hb%, TWDC, BUSE, GXM • X-Ray : Plaib Abd. Erect/SupineX-Ray : Plaib Abd. Erect/Supine • ECGECG • CT ScanCT Scan
  15. 15. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION This abdominal X-ray shows a stomach filled with fluid and a swollen (distended) small bowel, caused by a blockage (obstruction) in the intestines. A solution containing a dye (barium) that is visible on X-rays was swallowed by the patient (upper GI series).
  16. 16. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION This abdominal X-ray shows thickening of the bowel wall and swelling (distention) caused by a blockage (obstruction) in the intestines. A solution containing a dye (barium), which is visible on X-ray, was swallowed by the patient (the procedure is known as an upper GI series).
  17. 17. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION This abdominal X-ray shows an intestinal condition in which a loop of bowel has slipped into another section of bowel (intussusception), causing swelling, reduced blood flow, obstruction, and tissue damage. Intussusception requires emergency treatment (barium enema or surgery) to prevent intestinal tissue death (necrosis), intestinal perforation, peritonitis, and death.
  18. 18. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION DIAGNOSIS PERBEZAANDIAGNOSIS PERBEZAAN • Ac. CholecstitisAc. Cholecstitis • Ac. AppendicitisAc. Appendicitis • PGUPGU • Ac. PancreatitisAc. Pancreatitis
  19. 19. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION PENGENDALIANPENGENDALIAN • KonservativeKonservative • PembedahanPembedahan • NBM • RT • VS • IV • Ix • Analgesik • AB • CBD • Laprotomi
  20. 20. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION KOMPLIKASIKOMPLIKASI • DehidrasiDehidrasi • RenjatanRenjatan • PerforasiPerforasi • PeritonitisPeritonitis
  21. 21. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION Obstruction due to hernia Obstruction due to mesenteric occlusion Obstruction due to volvulus
  22. 22. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION Obstruction due to intussusception Obstruction due to tumor Obstruction due to adhesions
  23. 23. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION
  24. 24. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION
  25. 25. INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION
  • GeorgeMunthali

    May. 22, 2021
  • NurAmnani

    May. 18, 2020
  • StephannieJeanSy

    Jan. 29, 2017

Pengenalan asas mengenai INTESTINAL OBSTRUCTION

Views

Total views

5,711

On Slideshare

0

From embeds

0

Number of embeds

2

Actions

Downloads

105

Shares

0

Comments

0

Likes

3

×