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Laporan Kasus

Juni 2016

FAKULTAS KEDOKTERAN

UNIVERSITAS HASANUDDIN

HYDROPNEUOTHORA!

OLEH"

Nuru# In$a% P&r'i(i )111120*2

A+ Yusriana A,,a%ra )111120*-

.&ss& Ju/rana )111120*

Ar/a(a'i )111120**

P&/i/in3 R&si$&n

$r+ 4&n$a Anas'asia I

Dos&n P&/i/in3

$r+Lu'%5 A''a/i/i7 Sp+Ra$

DIBAWAKAN DALAM RANGKA TUGAS KEPANITERAAN KLINIK 

BAGIAN RADIOLOGI FAKULTAS KEDOKTERAN

UNIVERSITAS HASANUDDIN

MAKASSAR

2016

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HALAMAN PENGESAHAN

Yang be!an"a !angan "# ba$a% #n#& 'en(a!a)an ba%$a *

1+ N,,- In"a% Pe!#$# .111120/2

2+ A+ Y,#ana Aa%a .111110/

+ Bee 3,'ana .111120/44+ A'a$a!# .111120//

3,",- La5an Ka,* H("5ne,'!%a7

Te-a% 'en(e-ea#)an !,ga "a-a' ang)a )e5an#!eaan )-#n#) 5a"a bag#an Ra"#-g# Fa),-!a

Ke")!ean Un#8e#!a Haan,""#n+

  Ma)aa& 3,n# 2016

  Kn,-en Pe'b#'b#ng

 

$r+ Lu'%5 A''a/i/i7 Sp+Ra$ $r+ 4&n$a Anas'asia I

Menge!a%,#&

Ke5a-a Bag#an Ra"#-g#

Fa),-!a Ke")!eanUn#8e#!a Haan,""#n

Pro5+ Dr+ $r+u%a//a$ I#as7 Sp+Ra$8K9

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DAFTAR ISI

HALAMAN

PENGESAHAN ++++++++++++++++++++++++++++++++++++++++++++++++++++++++

DAFTAR

ISI ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

BAB 1 PRESENTASI

KASUS +++++++++++++++++++++++++++++++++++++++++++++++++++++++

BAB 2 TIN3AUAN PUSTAKA

999999++++++++++++++++++++++++++++++++

A+ PENDAHULUAN++++++++++++++++++++++++++++++++++++++++++++++++++++++++

++++++++++

B+ ANATOMI DAN

FISIOLOGI+++++++++++++++++++++++++++++++++++++++++++++++

.+ PATOFISIOLOGI PNEUMOTHORA: DAN EFUSI

PLEURA++

9+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

D+ RADIOLOGI999999999999999999+

E+ DIFFERENTIAL DIAGNOSIS++++++++++++++++++++++++++++++

9+++99

DAFTAR

PUSTAKA +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

2

4

10

10

10

14

1;

2;

4

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.A. I

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BAB II

TIN3AUAN PUSTAKA

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3,'-a% a#an '#n#'a- (ang !e"a5a! 5a"a! %a) !ega) a"a-a% 2/0>

00 '-+ b#-a a#an ),ang "a# 2/0 '- 100 > 200'-C& "a5a! "#!e',)an

H#5e-,en a8a),-e 

P-e,a $%#!e -#ne

K-a5 5a,

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 5eng##an a#an "#,",! !@en#), 5!e# 5a"a @! !%a7 -a!ea-

!ega)+ .a#an (ang ),ang "a# 100 '- /0 100 '-C& "a5a! "#5e-#%a!)an

"engan 5## -a!ea- "e),b#!, "an aa% #na %#n!a- "#'ana a#an a)an

 be),'5,- "### a'5#ng ba$a%+10

a+ Posisi '&3a: pos'&roan'&rior 8PA9

Pa"a 5e'e#)aan @! !%a7 ,!#n !ega)& a#an 5-e,a !a'5a) 

 be,5a 5ee-,b,ngan homogen yang 'en,!,5# !,)!, 5a, ba$a%

(ang b#aan(a e-a!#8e a"#5a) "engan 5e',)aan a!a e),ng be=a-an

"a# -a!ea- a!a )e 'e"#a- ba$a%+ Kaena a#an 'eng## ,ang %e'#!%a) 

e%#ngga =a#ngan 5a, a)an !e"ng keaa% en!a- %#-,& "an )a"ang>

)a"ang 'en"ng 'e"#a!#n,' )eaa% )n!a-a!eal.10

Ga'ba ;+ E@,# 5-e,a #n#!a+ S,",! .!5%en#, (ang !,'5,-

)aena e@,# 5-e,a

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Ga'ba 10+ E@,# P-e,a "e7!a

Ga'ba 11+ E@,# 5-e,a #n#!a 'a#@+ Ta'5a) 'e"#a!#n,'

!e"ng )n!a-a!e 

Ga'ba 12+ E@,# 5-e,a b#-a!ea-

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Ga'ba 1+ L,-a!e" 5-e,a- e@@,#n+ Ta'5a) beba!a ,),5 !ega "an b#n8e7+

Se#ng "#ebab)an -e% e'5#e'a "engan 5e-e)a!an 5-e,a-+

b. Posisi #a'&ra#

B#-a a#an ),ang "a# 2/0'- 100>200'-C& "a5a! "#!e',)an

 5eng##an a#an "#,",! !@en#), 5!e# 5a"a @! !%a) 

-a!ea- !ega)+ Pa"a 5ene-#!#an 'engena# '"e- en!gen 5a!-ogi

.--#n 'en,n=,))an ba%$a e"#)#!n(a 2/'- "a# a#an 5-e,a

a#an a-#ne (ang "#,n!#))anC 5a"a a"#ga' "a"a -a!ea- !ega) 

-,, "a5a! "#"e!e)# ebaga# a),',-a# a#an ,b5,-'n# "#

 5!e# ,-, !5%en#& !e!a5# %an(a "engan a"an(a

 5ne,'5e#!ne,' (ang !e=a"# ebe-,'n(a+10

Ga'ba 14+ Ga'baan e@,# 5-e,a 5a"a @! 5## -a!ea-

+ Posisi La'&ra# D&Bui'us

Ra"#ga@# "a"a -a!ea- "e,b#!, "#g,na)an e-a'a be!a%,n>

!a%,n ,n!,) 'en"#agn# e@,# 5-e,a (ang e"#)#!+ .a#an (ang ),ang

"a# 100 '- /0>100 '-C& "a5a! "#5e-#%a!)an "engan 5## -a!ea-

"e),b#!, "an aa% #na %#n!a- "#'ana a#an a)an be),'5,- "###

a'5#ng ba$a%+10

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Ga'ba 1/+ E@,# 5-e,a 5a"a 5## #g%! -a!ea- "e,b#!, 5en,'5,)an

a#an (ang "#!,n=,))an "engan 5ana% b#,C+

2++ H#"5ne,'!%a)

D#agn# 5a!# "a# %("5ne,'!%a) "#!ega))an "engan

 5e'e#)aan n!gen @! !a)+ Pa"a n!gen @! !a) PA a)an !e-#%a!

ga# 5eng,n,5an 5a, (ang %a-, e5e!# a'b,!+ A5ab#-a 5ne,'!%a)

"#e!a# "engan a"an(a a#an "# "a-a' ngga 5-e,a& 'a)a a)an !a'5a) 

ga'baan ga# "a!a (ang 'e,5a)an ba!a ,"aa "an a#an+ Seba#)n(a @!

!a) "#b,a! "a-a' )ea"aan e)5#a# 'a)#'a-+

Pa"a %#"5ne,'!%a) a#an 5-e,a e-a-, bea'a>a'a ,"aa&

a#an !eeb,! 'enga)#ba!)an #n, !@en#, !#"a) !e-#%a!+ Pa"a @!

!ega) !e-#%a! ga# 'en"a!a )aena a"an(a ,"aa "# a!a a#an+ Ga'baan

a"#-g# 5a"a %#"5ne,'!%a) #n# !e-#%a! ,ang 5-e,a %#5e-,en "engan

!#"a) !e-#%a!n(a ga'baan 5e'b,-,% "aa% 5a,& b#aan(a !a'5a) ga# 5,!#%

!ega (ang 'e'ba!a# 5-e,a 8#ea-# "engan 5-e,a 5a#e!a-& !a'5a) 

ga'baan e'#5a) %'gen 'en,!,5# 5a, ba$a%& "an 5en,'5,)an a#an

"# "a-a' a8,' 5-e,a (ang 'en(ebab)an #n, !@en#), 'en,'5,-+

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Ga'ba 16+ H("5ne,'!%a7

2++* P(5ne,'!%a7In@e!e" %("5ne,'!%a7 (ang "#'ana a#an 5a"a ngga 5-e,a

 be## ,"aa nana% 5,C "an (ang 'enan"a)an !e=a"#n(a #n@e)#+ Ga'baan

)%a (ang "#"a5a!)an 5a"a 5en(a)#! #n# a'a "engan %("5ne,'!%a7

na',n (ang 'e'be"a)an %an(a a#ann(a a=a+ Pa"a g'baan a"#-g#n(a

en"## !e"a5a! a#>@-,#" -e8e-& "an %a- #n# (ang 'e'b,a! ,a% ,n!,) 

"#be"a)an "engan %("5ne,'!%a7 !a5# 5a"a 5(5ne,'!%a7 b#aan(a

a"a 5-e,a- !%#) -#ne (ang 'en",),ng "#agn# 5en(a)#! #n#+

Ga'ba 1<+ P(5ne,'!%a7

2++6 Hae'5ne,'!%a7

Hae'!%a7 a!a, "aa% (ang a"a "a-a' 5a,>5a,& #!#-a% #n# b#aan(a

"#g,na)an 5a"a e@,# 5-e,a (ang !ea),',-a# "engan "aa%+ A5ab#-a

%ae'!%a7 !e=a"# "#e!a# "engan 5ne,'!%a7 'a)a "#eb,! =,ga "engan

%ae'5ne,'!%a7+ Pen(a)#! #n# b#aan(a )aena a"an(a )e=a"#an !a,'a

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"an =aang e)a-# !e=a"# 5a"a )e=a"#an nn>!a,'a+ Ga'baan a"#-g# "a#

 5en(a)#! #n#& (a#!, !e-#%a! !an"a "a# 5ne,'!%a) "an %ae'!%a)+ Tan"a

"a# 5ne,'!%a) "a5a! "#-#%a! "a# ,"aa "a-a' ngga 5-e,a 'e'be#)an

 ba(angan a"#-,en (ang !an5a !,)!, =a#ngan 5a, "engan ba!a 5a,

 be,5a ga# a"#5a) !#5#+ Daa% "#"a-a' 5a, "a5a! !e-#%a! 5a"a bag#an

"aa 5a,& "an ga'baan a# @-,#" -e8e- a)an !e-#%a!+ B#aan(a 5a"a @!

!%a7 "#e!a# "engan ga'baan @a)!, !,-ang (ang 'enan"a)an a"an(a

!a,'a+ Pa"a @! "engan 5## ,5#na# %an(a ga'baan %ae'!%a7 (ang

!e-#%a!+ 14

Ga'ba 1?+ Hae'5ne,'!%a7 "engan #b @a!,e

2+* Di5&r&nsia# Dia3nosis

2+*+1 Abe 5a,

Pa"a %#"5ne,'!%a7 a-a% a!, ga'baan a"#-g# (ang !a'5a) 

 5a"a @! !e=a"# ga'baan 5e'ben!,)an air fluid level  a)#ba! a"an(a ,"aa

"an a# (ang 'e'be#)an !a'5#-an "en#!an(a 'a#ng>'a#ng+ D#agn#

 ban"#ng "a# %#"5ne,'!%a7 (ang a'a be"aa)an ga'baan

 5e'ben!,)an a# @-,#" -e8e-n(a (a#!, abe 5a,+

Abe Pa, 'e,5a)an 5e ,5,a# (ang be-)a-## 5a"a

 5aen)#' 5a,+/ Ga'baan a"#-g# "a# abe 5a, (ang !e,!a'a (a#!, a# 

@-,#" -e8e-& "#'ana (aa! "#)a!a)an abe 5a, %a, "#"a5a!)ann(a e'5a! %a-

(a#!, *

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1C A"an(a a8#!a

2C Me'ben!,) A# @-,#" -e8e-&(ang 'e'be#)an "en#!a ,"aa (ang 'eng##

,ang a!a a8!a "an "en#!a a# (ang 'ene'5a!# bag#an ba$a% ,ang

a8#!a+

C Me'#-#)# "#n"#ng !eba- thick wall C (ang 'eng#-#-#ng# a8#!a a!a,

'e'ba!a# a8#!a =a#ngan 5a, (ang a)#!C "engan =a#ngan 5a, (ang

e%a!+ D#n"#ng #n# 'e'be#)an ga'baan "en#!a 5a) 6+

4C Ieg,-e B"e& (a#!, "#n"#ng -,a "a# )a8#!a (ang !#"a) bea!,an a!a,

a!a '!%C+

Abe 5a, "a5a! "#ebab)an ba#) -e% 5e #n@e)# e5e!# T,be,-#C

'a,5,n 5e )eganaan (a#!, a#n'a 5a,& "#'ana (ang 'e'be"a)an

)e",an(a (a#!, "#-#%a! "a# #nne 'ag#n a!a, "#n"#ng "a-a' a8#!a& "#'ana 5a"a

#n@e)# b#aan(a ',-, '!%C "an a#n'a 5a, n",-a )aa a!a, ,g%C+/

Be#),! n!% ga'baan "a# abe 5a,*

Ga'ba 1;+Abe Pa,

2+6 Ko/p#i:asi

1+ In@e)# e),n"e e%#ngga "a5a! 'en#'b,-)an 5-e,#!#& e'5#e'a&

%#"5ne,'!a)+

2+ Gangg,an %e'"#na'#)a+ Pa"a 5ne,'!a) (ang %eba!& e-,,%

'e"#a!#n,' "an =an!,ng "a5a! !egee )e aa% (ang e%a! "an

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'enga)#ba!)an 5en,,nan )a"#a) ,!5,!& e%#ngga "engan "e'#)#an "a5a!

'en#'b,-)an () )a"#gen#)+

-+ E'@#e'aJ "a5a! be,5a e'@#e'a ),!# a!a, e'@#e'a 'e"#a!#na-#+

E'@#e'a 'e,5a)an ,a!, 5e,ba%an ana!'# 5a, (ang "#!an"a# "engan

 5e,ba%an abn'a- a-,an ,"aa bag#an "#!a- bn), !e'#na-& (ang

"#e!a# )e,a)an"#n"#ng a-8e-,+ E'5#e'a (ang !e=a"# 'e,5a)an

e'@#e'a )'5ena# (ang 'e,5a)an ,a%a !,b,% eaa @##-g#) ,n!,) 

'enggan!#)an =a#ngan 5a, (ang !#"a) be@,ng#+

2+ Pro3nosis

D,b#a a" 'a-a' !#"a) !en!,& en"e,ng b,,)C

2+C K&si/pu#an

Pa"a )a, #n#& a)an "#=e-a)an -eb#% 'en"a-a' 5a"a %("5ne,'!%a7

(ang !e=a"#+ Tan"a>!an"a %e'5ne,'!%a7 5a"a @! "# a!a a"a-a% *

a+ H

#

 5

e

-,en a8a),-e 'e,5a)an ga'baan a# "en#!( a)#ba! a"an(a ,"aa beba

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"a-a' a8,' 5-e,a (ang 'e(ebab)an )-a5 bag#an 5a, (ang bea"a

"#ba$a% 5-e,a e%#ngga !#"a) !e-#%a! a)an bn%8a),-a 5a"a bag#an

!eeb,!+4&/ Tan"a #n# "#!an"a# "engan 5ana% 'ea% 5a"a @! 5- !%a7 "#

a!a+

 b+  Pleural white line 'e,5a)an ga'baan 5-e,a 8#ea-# (ang !e5#a% "a#

 5-e,a 5a#e!a-# -e% )aena a"an(a ,"aa "a-a' a8,' 5-e,a (ang

'e'#a%)an "#an!aa )e",a e-a5,! !eeb,!+4 Tan"a #n# "#-#%a! ebaga# ga#

 5,!#% !#5# (ang 'eng#),!# ben!,) =a#ngan 5a, (ang !e"ea) a)#ba! "ea)an

,"aa "#a!an(a+ Tan"a #n# "#!an"a# "engan 5ana% b#, 5a"a @! !%a7 "#a!a+

+ Pee-,b,ngan %'gen 'e,5a)an ga'baan e'#5a) a!a, #n!e'e"#e!

(ang 'en,!,5# bag#an 5a,+4  Tan"a #n# b#aan(a "#"a5a!)an a)#ba! a"an(a

 5en,'5,)an a#an "a-a' a8,' 5-e,a (ang 'e'be#)an !a'5#-an "en#!a

a#an 5a"a 5e'e#)aan a"#-g#+ Tan"a a"#-g# #n# "#!,n=,)an 5a"a

 5ana% %#=a, 5a"a @! !%a7 "# a!a+

"+  Air fluid level  'e,5a)an ga'baan a"#-g#) "#'ana !e-#%a! 5ena'5a)an

"en#!a ,"aa "an "en#!a a#an (ang !e5#a% "#'ana "en#!a ,"aa a# 

"en#!(C e-a-, 'ena'5a!# bag#an a!a "an "en#!a a#an @-,#" "en#!(C

'ene'5a!# ,ang "#ba$a%n(a+4&/  Pa"a )a, %#"5ne,'!%a7 !e=a"#

 5e'ben!,)an a# @-,#" -e8e- (ang "a5a! "#-#%a! 5a"a 5e'e#)aan a"#-g#&

a)#ba! a"an(a ,"aa "an a#an eaa bea'aan "a-a' a8,' 5-e,a+ Pa"a

,','n(a 5a"a 5en,'5,)an a#an "a-a' a8,' 5-e,a a)an 'e'ben!,) 

'en#, #gn 5a"a !a'5#-an a"#-g#& na',n 5a"a %("5ne,'!%a7

e-a#n a"an(a a#an =,ga !e"a5a! ,"aa (ang 'e'be#)an !e)anan "#a!a

 5e',)aan a#an e%#ngga 5a"a %e'5ne,'!%a7 !#"a) !eben!,) 'en#,

#gn e5e!# 5a"a e@,# 5-e,a b#aan(a+ Ta'5#-an !an"a #n# "#!,n=,)an "engan

ga# 5,!#% 5a"a @! !%a7 "# a!a+

Pa"a 5a#en #n#& 'enga-a'# !a,'a ben"a !a=a' (ang 'en(ebab)an

-aea# 5a, a!a, -aea# 5e'b,-,% "aa% #n!e)!a- a!a, a!e# 'a'a#a

#n!ena e%#ngga 'en(ebab)an 5e"aa%an+ Pe"aa%an b#aan(a be#@a! e-@ 

-#'#!e" "an !#"a) 'e'e-,)an #n!e8en# 5ea!#@+

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DAFTAR PUSTAKA

1+ A#- Ba%a& 1;;;& Pen(a)#! 5en(a)#! P-e,a& B,), A=a Pen(a)#! Da-a'& 3#-#" II&

Ba-a# Peneb#! FKUI& 3a)a!a

2+ D-an+ Kamus Saku Kedokteran Dorland. 3a)a!a* EG.+ 2011J Ha-+ 12/<++ G,(!n "an Ha--+  Buku Ajar Fisiologi Kedokteran Edisi 1. 3a)a!a* EG.+201J Ha-+

4><1+

4+ S%e$"& La,a-ee+  Fisiologi !anusia dari Sel Ke Sisitem Edisi ". 3a)a!a* EG.+

2011J Ha-+ 411>4/?+

/+ Pa!' IP& Y,n, F+  Anatomi dan Fisiologi Pleura+De5a!e'en P,-'n-g# "an

I-', Ke")!ean Re5#a#& Fa),-!a Ke")!ean Un#8e#!a In"ne#aRSUP

Pea%aba!an& 3a)a!a& In"ne#a+ 201+ Ha-+ 40<>412+6+ S,"( A, W& Se!#%a"# B& "))+ 2012+ B,), A=a* I-', Pen(a)#! Da-a'+ E"## V+

3a)a!a* In!enaP,b-#%#ng

<+ D+ R+ Da'an! D=="#b!& S5+ P& F..P 2014C+ Re5#-g# e5#a!(Me"##neC+

3a)a!a* EG.+

?+ A+ P#e S(-8#a& M+W#-n La#ne+ 2012 +  Patofisiologi # Konse$ Klinik Proses%

 Proses Pen&akit + E"## 6+ 3a)a!a * EG.

;+ Be& A& 200/+ U-!anga@#+ Da-a'* Raa"& S=a%#a+ Ra"#-g# D#agn!#)E"##

Ke",a+ 3a)a!a* Ba-a# Peneb#! FK UI

10+ A'e#an .--ege @ S,gen .''#!!ee @ Ta,'a&2004+A"8ane" Ta,'a L#@e

S,55! Se8en!% E"#!#n+In"ne#a* I)ab#

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11+ Tan! .& L#$ang F& Han#@a!# S& Pa"#5!a EA+ 2014+ Ka$ita Selekta Kedokteran+ E"##

IV+ 3a)a!a* Me"#a Ae,-a5#,

12+ Raa" S=a%#a+ 201/+ 'adiologi Diagnostik + E"## 2+ 3a)a!a* Ba"an Peneb#! FKUI

1+ E$#nga+200;+ E@,#P-e,a. D#a)e "a# 

% !! 5 * e5 # !(+, #+a + #" n !en ! ) -e) # 11 e@, #5 -e, a+5"@ 

14+ Ha-#'&Ha"#+ Pen(a)#!Pen(a)#!P-e,a+B,), A=a I-',Pen(a)#!Da-a'3#-#" II+200<+

Ba-a#Peneb#!FK UI 3a)a!a+

1/+ O'aLababe"e&"))+ 2011+ P-e,a-E@@#n

I'ag#ng&$ $$+e ' e" # #ne + ' e"a5e + '

16+ B)a )a'an& "))+ 2014+ E'5(e'a+ Me"##ne+'e"a5e

1<+ %!!5*$$$+T,)#%e5#a!( =,na-+' "#a)e !angga- 20 Me# 2016C

1?+ A-aga@@ H& M,)!# A+ Daa>Daa I-', Pen(a)#! Pa, A#-angga Un#8e#!( Pe+e"##

2+ S,aba(a* 2002+

1;+ A'#,--% R+ Pena!a-a)anaan Pne,'!a) "# "a-a' Pa)!e)+ %!!5*$$$+

)a-be++#" "#a)e !angga- 20 Me# 2016C