DAFTAR ISI

DAFTAR ISI .............................................................................................. iii

DAFTAR GAMBAR ................................................................................. v
DAFTAR TABEL ..................................................................................... vi
BAB I PENDAHULUAN
1.1 Latar Belakang ............................................................................. 1
BAB II STATUS PENDERITA
2.1 Identitas ....................................................................................... 3
2.2 Anamnesis ................................................................................... 3
2.3 Pemeriksaan Fisik ........................................................................ 5
2.4 Pemeriksaan Penunjang ............................................................... 7
2.5 Terapi ........................................................................................... 9
2.6 Prognosis ..................................................................................... 9
2.7 Hasil Follow Up........................................................................... 9
BAB III TINJAUAN PUSTAKA
3.1 Sirosis Hepatis
3.1.1 Definisi ............................................................................ 11
3.1.2 Epidemiologi ................................................................... 11
3.1.3 Etiologi ............................................................................ 13
3.1.4 Klasifikasi ........................................................................ 14
3.1.5 Patogenesis ...................................................................... 16
3.1.6 Gejala ............................................................................... 16
3.1.7 Temuan Klinis ................................................................. 17
3.1.8 Diagnosis ......................................................................... 19
3.1.9 Penatalaksanaan ............................................................... 21
3.1.10 Prognosis ......................................................................... 26
3.1.11 Komplikasi....................................................................... 27
3.2 Varises Esofagus
3.2.1 Definisi............................................................................. 32
3.2.2 Epidemiologi .................................................................... 32
3.2.3 Patofisiologi ..................................................................... 33

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 3.2.4 Perjalanan Alamiah Varises ............................................. 37
3.2.5 Diagnosis ......................................................................... 38
3.2.6 Penatalaksanaan ............................................................... 38
3.2.7 Terapi Klinis .................................................................... 40
3.2.8 Prognosis .......................................................................... 43
BAB IV KESIMPULAN ........................................................................... 45
DAFTAR PUSTAKA ................................................................................ 46

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 DAFTAR GAMBAR

Gambar 3.1 Sirosis Makronodular .............................................................. 15

Gambar 3.2 Sirosis Mikronodular ............................................................... 15
Gambar 3.3 Eritema Palmaris ..................................................................... 17
Gambar 3.4 Kontraktur Dupuytren ............................................................. 18
Gambar 3.5 Epidemiologi varises esofagus dan korelasinya dengan tingkat
keparahan penyakit hati............................................................................... 33
Gambar 3.6 Patofisiologi hipertensi porta pada sirosis hati ........................ 35
Gambar 3.7 Skema Patofisiologi Varises Esofagus .................................... 36
Gambar 3.8 Patogenesis Hipertensi Portal .................................................. 37
Gambar 3.9 Perjalanan Alamiah Varises dan Perdarahan Pada Pasien dengan
Sirosis .......................................................................................................... 37
Gambar 3.10 Tabel Guideline Esophageal Varices .................................... 38
Gambar 3.11 Terapi Farmakologi Varises Esofagus .................................. 39
Gambar 3.12 Terapi Endoskopik Varises Esofagus .................................... 39
Gambar 3. 13Terapi Pasien dengan Sirosis tanpa Varises .......................... 40
Gambar 3.14 Terapi Pasien dengan Sirosis dan Small Varices .................. 40
Gambar 3.15 Terapi Pasien dengan Sirosis dan Medium or Large Varices, tetapi
Tidak ada Perdarahan .................................................................................. 41
Gambar 3.16 Terapi Pasien dengan Sirosis dan Perdarahan Varises Akut . 41
Gambar 3. 17 Terapi Pasien dengan Sirosis yang telah Sembuh dari Perdarahan
Varises Akut ................................................................................................ 42
Gambar 3.18 Rekomendasi untuk manajemen lini pertama pasien sirosis pada
setiap tahap dalam perjalanan alami varises ............................................... 43

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 DAFTAR TABEL

Tabel 2.1 Pemeriksaan Laboratorium 06 Juli 2017 .................................... 7

Tabel 2.2 Pemeriksaan Laboratorium 07 Juli 2017 .................................... 8
Tabel 2.3 Pemeriksaan Laboratorium 08 Juli 2017 .................................... 8
Tabel 2.4 Pemeriksaan Laboratorium 10 Juli 2017 .................................... 8
Tabel 2.5 Hasil Follow Up .......................................................................... 9
Tabel 3.1 Skor Child-Pugh ......................................................................... 20

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