LEMBAR PENGESAHAN

Presentasi Kasus

Diajukan guna melengkapi tugas internship

Di RSUD Sejiran Setason, Bangka Barat

Periode 2019-2020

Disusun Oleh:

dr. Cahaya Putri Lestari

Telah disetujui

Oleh :

Pembimbing Pendamping

(dr. Yogi Yamani, Sp.B) (dr. Femmy V K)

I
 DAFTAR ISI
Lembar Pengesahan ...............................................................................................................I
Daftar Isi ................................................................................................................................II
Daftar Tabel ..........................................................................................................................III
Daftar Gambar .......................................................................................................................IV
BAB I Pendahuluan ...............................................................................................................1
BAB II Ilustrasi Kasus ...........................................................................................................2
2.1 Identitas Pasien ..........................................................................................................2
2.2 Anamnesis ..................................................................................................................2
2.3 Pemeriksaan Fisik ......................................................................................................3
2.4 Pemeriksaan Penunjang .............................................................................................5
2.5 Diagnosis....................................................................................................................7
2.6 Tatalaksana ................................................................................................................7
2.7 Prognosis ....................................................................................................................8
2.8 Follow Up ..................................................................................................................8
BAB III Tinjauan Pustaka ......................................................................................................12
3.1 Anatomi Inguinal Canal .............................................................................................12
3.2 Hernia .........................................................................................................................13
3.2.1 Definisi ...........................................................................................................13
3.2.2 Anatomi Hernia ..............................................................................................13
3.2.3 Epidemiologi ..................................................................................................14
3.2.4 Etiologi ...........................................................................................................15
3.2.5 Klasifikasi ......................................................................................................16
3.2.6 Patofisiologi Hernia Inguinalis ......................................................................25
3.2.7 Diagnosis Hernia ............................................................................................26
3.2.8 Pemeriksaan Penunjang .................................................................................29
3.2.9 Diferensial Diagnosis .....................................................................................30
3.2.10 Penatalaksanaan Hernia .................................................................................30
3.2.11 Komplikasi Hernia ........................................................................................32
3.2.12 Prognosis ........................................................................................................33
BAB IV Analisis Kasus .........................................................................................................34
BAB V Daftar Pustaka ...........................................................................................................35

II
 DAFTAR TABEL

Tabel 2.1 Pemeriksaan Fisik Pasien.......................................................................................3

Tabel 2.2 Hasil Laboratorium ................................................................................................4
Tabel 2.3 Hasil EKG ..............................................................................................................6
Tabel 2.4 Follow Up Pre Op ..................................................................................................8
Tabel 2.5 Follow Up Post Op Hari 1 .....................................................................................9
Tabel 2.6 Follow Up Post Op Hari 2 .....................................................................................10
Tabel 2.7 Follow Up Post Op Hari 3 .....................................................................................11

III
 DAFTAR GAMBAR

Gambar 2.1 Foto Thorax ........................................................................................................6

Gambar 2.2 Hasil EKG ..........................................................................................................6
Gambar 2.3 Luka Jahitan Post Op hari 3 ...............................................................................10
Gambar 3.1 Inguinal Canal dalam Pelvic Basin ....................................................................12
Gambar 3.2 Batas Inguinal Canal ..........................................................................................13
Gambar 3.3 Bagian dari Hernia .............................................................................................14
Gambar 3.4 Prevalensi Hernia Berdasarkan Usia ..................................................................14
Gambar 3.5 Frekuensi Relatif Hernia Berdasarkan Tipe Hernia ...........................................15
Gabmar 3.6 Gambar 3.4 Penyebab Hernia Inguinal ..............................................................16
Gambar 3.7 Faktor Resiko Hernia .........................................................................................16
Gambar 3.8 Hernia Berdasarkan Lokasi ................................................................................17
Gambar 3.9 Klasifikasi Menurut Nyhus ................................................................................19
Gambar 3.10 Hernia Richter ..................................................................................................20
Gambar 3.11 Hernia Sliding (Geser) .....................................................................................20
Gambar 3.12 Hernia Spiegel ..................................................................................................21
Gambar 3.13 Hernia Littre .....................................................................................................21
Gambar 3.14 Hernia Obturatoria ...........................................................................................21
Gambar 3.15 Hernia Labialis .................................................................................................21
Gambar 3.16 Hernia Perinealis ..............................................................................................22
Gambar 3.17 Hernia Pantalon ................................................................................................22
Gambar 3.18 Hernia Amyand ................................................................................................22
Gambar 3.19 Anatomy Regio Inguinal dari posterior ...........................................................23
Gambar 3.20 Triangle Hasslebach pada Direct Hernia .........................................................23
Gambar 3.21 Perbedaan Hernia Inguinalis Lateralis dan Medialis .......................................24
Gambar 3.22 Patofisiologi Hernia Inguinalis ........................................................................26
Gambar 3.23 Pemeriksaan Fisik Hernia Inguinalis ...............................................................27
Gambar 3.24 Herniography pada Direct Inguinal Hernia ......................................................29
Gambar 3.25 CT Scan Hernia Inguinalis Dextra ...................................................................29
Gambar 3.26 Benjolan lain yang harus dibedakan dari hernia pada dinding abdomen .........30
Gambar 3.27 Algoritma Manajemen Inguinal Hernia Awal .................................................31
Gambar 3.28 Herniorrhapy/Hernioplasty ..............................................................................31

IV