seminar widodo

8/19/2019 Seminar Widodo

1/40

dr Ajie Rakhmadi SpBARs Widodo

KEGAWATDARURATANKASUS BEDAH ANAK


2/40

KASUS I


3/40


4/40

KASUS II


5/40


6/40

KASUS III


7/40


8/40

KASUS BEDAH/NON BEDAH

KASUS EMERGENSI/TIDAK

PENATALAKSANAAN AWAL

KASUS BEDAH ANAK


9/40

Cairan dan elektrolitAa!"BaaS#$#

TIGA STABILITAS %


10/40

Jumlah

PROGRAM CAIRAN !

"AM #$


11/40

Jumlah cairan :

1. Defisit cairan / dehidrasi

a. Dehidrasi Ringan : 5% ( 50ml/kgbb x TBW )

b . Dehidrasi Sedang : 10% (100ml/kgbb x TBW )

c. Dehidrasi Bera : 15% (150ml/kbbb x TBW )

! T"nisias darah:#i$""nisis""nishi$er"nis


12/40

TOTAL BODY WATER ( ASHCRAFT )

&'&R %

esasi"nal 1* mingg+ ,-

1* mingg+ * mingg+ 0

erm

5 hari 2

5

3e"na+s 25 0

4hildren 5 25

6"+ng 'an 06"+ng W"man 50

78er 0 9ears man 50

78er 0 9ears "men -5


13/40

O!&alokel ' Gatro($iiD#kt# o!&aloenterik#Hernia/ e)enteraio dia&ra*!atikaAtreia eo&a*# d*/ tan+a ,t#la trakeaAtreia d#odeni ' !alrotai erta SPH

-STENOSIS PILORIK HIPERTRO.I

Atreia intetinal 0e0#n#!/ ile#!Atreia aniMor1# $ir($+r#n*Hernia in*#inali ' in)a*inai

BEDAH

EMERGENSI


14/40

Ditre +erna+aanHi+erali)aiGER 2 3 !*Ikterik 2 4 !*DISTENDED ABDOMEN

Mekoni#! terla!1at5 46 0a! / !ekoni#! tdk

kel#arM#nta$ $i0a#/ &ae(eKelainan ##nan anato!i

GE7ALA KLINIS NEONATUSKECURIGAAN CACAT BAWAAN


15/40

OMPHALOCELE

GASTROSCHI8IS


16/40

OBSTRUCTION % 9ES/ NO SIMPLE OR STRANGULATION

HIGH OR LOW OBSTRUCTION PARTIAL OR TOTAL MECHANIC OR .UNCTIONAL S9STEMIC COMPLICATION LOCAL COMPLICATION

I L E U S

- INTESTINAL OBSTRUCTION


17/40

PROBLEM ILEUS


18/40

TERIMAKASIH


19/40

THE DIGESTI:E S9STEM

.OREGUT% PHAR9N;< LOWER RESPIRATOR9 TRACT<OESOPHAGUS< GASTER< DUODENUM


20/40

MAL.ORMASI .OREGUT

OESOPHAGEAL ATRESIA%HIPERSALI:ASI

E;TRAHEPATIC BILIAR9 ATRESIA % ICTERIC 2 4?k

TIMING &or OPERATION% 4MONTH o& a*e

T@% KASAI PROCEDURE

-PORTOENTEROSTOM9


21/40

MAL.ORMASI MIDGUT

" DI:ERTICULUM

MACKEL

" MALROTASI

" OMPHALOCELE

" HERNIA UMBILIKALIS

" GASTROCHISIS


22/40

MALROTASI":OL:ULUS


23/40

MAL.ORMASI HINDGUT

ANORECTAL MAL.ORMATION


24/40

-A Ste+$en Tin**i Inter!ediet PC Line Renda$

-B Win*+read Tin**i Inter!ediet I Line Renda$

-C Pena Tin**i Renda$ >(! anal )er*e

In)erto*ra!% ; RAS PC-P#1o(o(*eal Line I Line-I($idi(# !a0or line

T@/ PSARP - POSTERO SAGITAL ANORECTO

PLASTI

ANORECTAL MAL.ORMATION


25/40

MEGAKOLON- HIRSCHSPRUNG DISEASE

A@% Mekoni#! 2 46 7AM

Tria Ile# % OBSTIPASI<

DISTENDED

MUNTAH

P@% Ile# letak renda$

Ro% Bari#! ene!a"CIL

8ONA TRANSISI KOLON DILATASI 'SPASTIK 9GMEN9EMPIT

Bio+i% PA -PATOLOGI ANATOMI Ko!+likai TO;EMIA " ENTEROKOLITIS


26/40

PEMERIKSAAN ENEMA-KOLON INLOOP"REKTOGRA.I

Ta!+ak ona tranii" 1ata +ada kolonrektoi*!oid antara 1a*ian a*an*lioner-+ene!+itan dan *an*lioner - dilatai


27/40

MEGAKOLON-HIRSCHSPRUNG DISEASE

Nor!al F = +le@# % A#er1a($ -Lon*it#dinal ' circular

muscle

Henle - deep sub mucosal plexus

Meiner - M#koa

.#n*i !en*at#r a1or1i< ekrei<aliran dara$ ' kontraki * e(aranor!al le1i$ do!inan * relakai

-1er$#1 S(r rit!ik ke koliner*ik+re*an*lioner ' adrener*ik+ot*an*lionik edan*kan re(t#!!en*adakan reek 1ila ada re*an*an


28/40

HD% Tidak terda+atna +le@#

+le@# tere1#t diata F e&ekkontraki/+atik le1i$ do!inan

NParai!+ati% !otorikne#rotrani!eter Aetilk$olin

2 K$olineterae

A*an*lioner 3J Re(toi*!oid

T@/ Proed#r S?enon


29/40

OPERASI DE.INITI. MEGAKOLON


30/40

Ke*a*alan !e!1ran +le#ro+eritoneal!en#t#+ al#ran +eri(ardio+eritonealHERNIA BOCHDALECHERNIA MORGAGNI

HERNIA DIAPHRAGMATICA


31/40

Hernia dia&ra*!ati(a


32/40

STENOSIS P9LORIC HIPERTROPH9-SPH

USG

OMD


33/40

A@% Neonat# NEONATUS 4"=!*< !#nta$ tdk $i0a# -e+erti* di!in#!< +roektil< +eriten< &ail#re to t$ri)e

P@% PALPABLE MASS OLI:E

USG% TARGET SIGN

OMD-OESOPHAGUS MAAG DUODENUM % SINGLE BUBBLE

T@% PYLOROMIOTOMY FREDET- RAMSTED

STENOSIS P9LORIC HIPERTROPH9-SPH


34/40

PANKREAS ANNULARE

A;% M#nta$ $i0a#

P@% Ile# letak tin**i

Ro% Plain do#1le 1#11le< OMD


35/40

ATRESIA ILEUMIntestinal Atresias are classified :

Type I - mucosal membrane or web

Type II - blin end separated by a fibrous cord

Type III a - blind ends separated by a

mesenteric defect

Type III b - usually aproximal eunal atresiawith a lar!e mesenteric !ap in

which the distal bowel is

precariously supplied by

a branch of the ilocolic" ri!ht

colic" or inferior mesenteric artery#also $nown as % Apple &eel% or

%'hristmas Tree% deformity)

Type I( - multiple intestinal atresias


36/40

ATRESIA INTESTINALAtreia D#oden#!

Atreia Ile#!


37/40

STRANGULASI:OL:ULUS ILEOCOECAL

A@% Neri tran*#lai

P@% Ile# tran*#lai

KU 0elek"ok

T@% Reeki $ort 1o?el ndro!e


38/40

STRANGULASIIN:AGINASI -INTSSS!EPTIONS

A%$ &e'' (ei)* (a(+

s,ra)*-'a,ed pai)

i).a), /0 12 mo3o'd peaki)4ide)s 5 mo o'd#

m-4o-s0red de.e4a,io)

P%$ I'e-s 'o&er 'e6e' ear'+# ,o

s,ra)*-'a,ed 'a,e#

a(domi)a' mass

Ro $ p'ai)0 4oi' spri)* 4o'o) i)'oop 0 4-ppi)*

DD$ Amoe(iasis d+se),r+

T%$ Bari-m Red-4,io)

7aparo,om+ Opera,ion


39/40

INGUINAL REGIONMAL.ORMATION

Hernia in*#inali lat

Hidrokel

UDT -u"desce"sus#es#is

T#!or teti


40/40

ILEUS -COMPARTEMENT S9NDROME-KOMPRESI< DEHIDRASI

seminar widodo

Documents