LEARNING TASK

PHLEGMON

SUBMITTED BY SMALL GROUP DISCUSSION B5:

Anak Agung Ngurah Satya Pranata (1602511194)


Haikal Hamas Putra Iqra (1602511099)

Anthony Wijaya (1602511120)

Ni Luh Gede Ayu Candranita Dharmadi (1602511105)

Grace Abigail (16012511049)

Michelle Putri Hindrato (1602511030)

Jonathan Adrian (1601511210)

Pande Putu Sucahaya Pradhana (1602511188)

Made Pradipa Yogyarta Pinatih (1602511170)

Evit Fitri Yana Binti Ependi (1602511238)

Amirah Syahirah (1602511243)
Latha Ghanesan (1602511247)

FACULTY OF MEDICINE
UDAYANA UNIVERSITY
DENPASAR
2019
LEARNING TASK PPT :
1. Coba diskusikan dan peragakan cara pemeriksaan ekstra oral yang anda lakukan saat menemui
pasien dengan suspek phlegmon
- pemeriksaan ekstra oral suspek phlegmon
• inspeksi -> kemerahan, bengkak, unclear margin, locking jaw
• palpasi -> keras atau kaku saat palpasi, sangat nyeri
• anamnesis -> demam
- pemeragaan :
• submandibular space -> dipalpasi di bawah submandibula
• submental space -> dipalpasi ke arah anterior tepat di bawah dagu
• sublingual space -> terlihat secara ekstraoral. pasien susah menelan, dinding dan mulut
terlihat penuh karena lidah terangkat
2. Sebagai dokter jika menemukan kasus phlegmon, tindakan apa yang akan anda lakukan,
silahkan disusun dalam bentuk SOP yang dapat dirangkum dari kondisi dan kegawat daruratan
pasien yang anda ketahui dalam kasus phlegmon.
- perbaiki kondisi umum pasien
• kontrol jalan nafas
• kontrol cairan
- antibiotik dosis tinggi
• penisilin G 2.000.000 unit/8 jam atau clindamycin 300 mg/8 jam
• metronidazol N (mulai infus)
- antiinflamasi
• steroid, dexamethason injeksi
• nonsteroid/ ketoprofen injeksi
- insisi dan drainase
• insisi
• pemasangan drain
• cabut gigi penyebab
- diet
• karbohidrat dan protein ditingkatkan
• kontrol cairan dan konsumsi vitamin
3. Dalam penatalaksanaan pasien yang terdiagnosa phlegmon, sebagai seorang dokter tentu akan
berkolaborasi dengan beberapa sejawat dan para dokter spesialis, coba contohkan bentuk
komunikasi interdisipliner yang dapat anda lakukan. (dalam bentuk tertulis)
- akan merujuk ke dokter gigi/ bedah dengan surat rujukan
4. Sebagai seorang dokter instruksi apa saja yang anda berikan pada keluarga pasien/ yang
mengantar pasien saat seorang pasien sudah terdiagnosa phlegmon, agar pasien mendapat
petolongan dan keluarga dapat memahami tindakan yang akan dilakukan, silahkan diperagakan.
- penjelasan tentang phlegmon

LEARNING TASK STUDY GUIDE

1. Patient female, 28 years old, with complaints of pain in the lower chin, up to the front of the
neck feel hard when touched, fever, difficulty swallowing and difficulty breathing, the patient
appears weak. Intra-oral examination is difficult because patients with difficulty opening the
mouth, tongue looks lifted and swelling of the gums behind that cover most of the right
mandibular M3. Pain in the gums behind the perceived than 4 days ago, the patient just gargling
with warm salt water when not withstand the pain.

a. As a doctor what would you do?
- inspect for signs of cellulitis
- take samples for culture
b. What examinations will you do for this case?
- culture studies
- palpations
c.What is the diagnosis?
- phlegmon
d. What does your planning for management in this case?
- high dose ABs
- symptomatic medication
- incision and drainage
2. Patient male, 38 years old, come to RSPTN with dread because of the pain that is felt in
mandibulla left with swelling to the left cheek, intra oral condition appears to exist in the dental
caries with mobillity o2 M2 residual roots on the left, buccal fold appears elevated, palpation
there is fluctuation exudate. Dental pain is felt starting from 3 days ago but have not had time to
 check to the dentist, just buy painkillers to reduce the pain.

a. What you should ask to complete the anamnesis?
- do you have any difficulty breathing?
- do you have fever?
b. What is the diagnosis?
- submandibular abscess
c. What does your planning for management in this case?
- antibiotics
- drainage if necessary
3. Patient woman, 38 years old, with complaints mandibulla swollen and hard when touched on
the lower jaw side since a few months ago, seemed teeth no complaints. There is no pain and
illness but the patient had never examined the situation to the doctor or dentist.
a. What you should ask to complete the anamnesis?
- ask about its family history
- ask about its medical history
b. What is the diagnosis?
- suspect tumor -> periodontal cyst
c. What does your planning for management in this case?
- x ray
- tumor removal