Ulkus Peptikum
Ulkus Peptikum
FAKULTASKEDOKTERAN
UNIVERSITASPATTIMURA
REFERAT
JULI2016
ULKUS PEPTIKUM
`
OLEH:
ROSIDA SUHAIMI
NIM. 2015-84-010
PEMBIMBING:
DR. HELFI NIKIJULUW, SP. B- KBD
DIBAWAKANDALAMRANGKATUGASKEPANITERAANKLINIK
BAGIANBEDAHRUMAHSAKITUMUMDAERAHDR.M.HAULUSSY
FAKULTASKEDOKTERANUNIVERSITASPATTIMURA
AMBON
2016
PENDAHULUAN
1. Barazandeh F, Yazdanbod A, Pourfazi F, Sepanlou SG, Derakhshan MH, Malekzadeh R. epidemiology of peptic ulcer
disease: Endonscopic results of a systemic investigation in Iran. Middle East Journal of Digestive Disease. 2012 Apr;
4(2):90-96.
2. Siddique RAH. Prevalence of peptic ulcer disease among the patients with abdominal pain attending the department of
medicine in Dhaka medical college hospital Bangladesh. JDMS. 2014 Peb. 13(1):5-20
3. Fendrick AM, Forsch RT, Harrison RV, Scheiman JM. Peptic ulcer. [internet] 2015 May [cited 2016 Jul 26]:[7 sheets].
Available from URL: https://www.med.umich.edu/1info/fhp/practiceguides/newpud/pud/pdf.
4. Duffon J. The pathophysiology and pharmaceutical treatment of gastric ulcers. [internet] 2015 Aug 03 [cited 2016 Jul 26]:
[21 sheets]. Available from URL: https://www.freece.com/files/classroom/programslides/pdf.
ANATOMI
Lambung
Waugh A , Grant A. Ross and Wilson Anatomy and Physiology In Health and Illness.
Spain: Churchill livingstone; 2004.
Duodenum
Waugh A , Grant A. Ross and Wilson Anatomy and Physiology In Health and Illness.
Spain: Churchill livingstone; 2004.
FISIOLOGI
Sel musin lendir,
terutama terletak di
bagian atas
Sel utama
pepsinogen
Sel parietal HCl dan
faktor intrinsik Castle.).
sel argentafin yang
tersebar, yaitu sel yang
dapat dipulas dengan
perak dan mempunyai
fungsi endokrin
Waugh A , Grant A. Ross and Wilson Anatomy and Physiology In Health and Illness.
Spain: Churchill livingstone; 2004.
Waugh A , Grant A. Ross and Wilson Anatomy and Physiology In Health and Illness. Spain: Churchill livingstone; 2004.
LANJUTAN
DEFINISI
Defek pada mukosa gastrointestinal yang meluas
keluar melewati muskularis mukosa
ulkus peptikum bakteri Helicobacter pylory
atau penggunaan obat anti inflamasi non steroid
(OAINS).
Norton JA, Barie PS, Bollinger RR, Chang AE, Lowry SF, Mulvihill SJ, et al. Surgery basic science and clinical
evidence. 2nd Ed. USA: Springer; 2008.
University of Maryland. Peptic ulcer. [internet] 2013 [cited 2016 Jul 20]:[17 sheets]. Available from URL:
https://www.umm.edu/health/medical/altmed/condition/peptic-ulcer/pdf
EPIDEMIOLOGI
Insidens ulkus peptik di USA sekitar teradapat
500.000 kasus baru dan 4 juta kasus rekuren
setiap tahun
Di Negara-negara industri, prevalensi infeksi H.
pylori meningkat sesuai usia.
Sekitar 500.000 kasus baru ulkus petik
didiagnosis setiap tahun, dengan variasi gaster
sekitar 16%.
Antara 80.000 sampai 90.000 ulkus gaster
didiagnosis setiap tahun di US
ETIOLOGI
Norton JA, Barie PS, Bollinger RR, Chang AE, Lowry SF, Mulvihill SJ, et al. Surgery basic
science and clinical evidence. 2nd Ed. USA: Springer; 2008
Norton JA, Barie PS, Bollinger RR, Chang AE, Lowry SF, Mulvihill SJ, et al. Surgery basic
science and clinical evidence. 2nd Ed. USA: Springer; 2008
KLASIFIKASI
Ulkus gaster
Ulkus duodenal
Ulkus stress
Norton JA, Barie PS, Bollinger RR, Chang AE, Lowry SF, Mulvihill SJ, et al. Surgery basic
science and clinical evidence. 2nd Ed. USA: Springer; 2008
PATOFISIOLOGI
Pathogenesis ulkus
peptikum
University of Maryland. Peptic ulcer. [internet] 2013 [cited 2016 Jul 20]:[17 sheets]. Available from URL:
https://www.umm.edu/health/medical/altmed/condition/peptic-ulcer/pdf
MANIFESTASI KLINIS
Anamnesis
Riw. medis, terutama untuk penyakit ulkus
peptikum, infeksi H. pylori, ingesti OAINS, atau
merokok
Anand BS, Katz J. Peptic ulcer disease. [internet] 2015 Jan 09 [cited 2016 Jul 26]:[10 sheets]. Available from URL:
https://www.emedicine.medscape.com/article/181753-overview
Pemeriksaan fisik
Temuan klinis yang nonspesifik nyeri tekan
epigastrium (biasanya ditengah, nyeri tekan
kuadran kanan atas (etiologi bilier, atau ulkus
peptikum)
Anand BS, Katz J. Peptic ulcer disease. [internet] 2015 Jan 09 [cited 2016 Jul 26]:[10 sheets]. Available from URL:
https://www.emedicine.medscape.com/article/181753-overview
LANJUTAN
Radiografi
University of Maryland. Peptic ulcer. [internet] 2013 [cited 2016 Jul 20]:[17 sheets]. Available from URL:
https://www.umm.edu/health/medical/altmed/condition/peptic-ulcer/pdf
Fashner J, Gitu AC. Diagnosis and treatment of peptic ulcer disease and H. pylori infection. American
Academy of family Physicians; 2015
Stool monoclonal
antigen test
stool antigen test
mendeteksi infeksi
aktif dan dapat
digunakan untuk tes
pengobatan
Tes serologi
Fashner J, Gitu AC. Diagnosis and treatment of peptic ulcer disease and H. pylori infection. American
Academy of family Physicians; 2015
Direkomendasikan mengesampingkan
kanker dan penyebab serius lainnya pada
pasien 55 tahun atau lebih, atau dengan
satu atau lebih yang memiliki gejala alarm
LABORATORIUM
Fashner J, Gitu AC. Diagnosis and treatment of peptic ulcer disease and H. pylori infection. American
Academy of family Physicians; 2015
PENATALAKSANAAN
Prinsip pengobatan medis menghindari faktor
pendorong terjadinya ulkus dan mengobati
infeksi H. pylori dengan regimen antibiotik.
Pengendalian faktor yang memperberat penyakit
Eradikasi H. pylori direkomendasikan pada
semua pasien dengan ulkus peptikum.
Fashner J, Gitu AC. Diagnosis and treatment of peptic ulcer disease and H. pylori infection. American Academy of family
Physicians; 2015.
Talley NJ, Vakil N; Practice Parameters Committee of the American College of Gastroenterology. Guidelines for the
management of dyspepsia. Am J Gastroenterol. 2005;100(10):2324-2337.
Fashner J, Gitu AC. Diagnosis and treatment of peptic ulcer disease and H. pylori infection. American Academy of
family Physicians; 2015
Duffon J. The pathophysiology and pharmaceutical treatment of gastric ulcers. [internet] 2015 Aug 03 [cited 2016
Jul 26]:[21 sheets]. Available from URL: https://www.freece.com/files/classroom/programslides/pdf
Duffon J. The pathophysiology and pharmaceutical treatment of gastric ulcers. [internet] 2015 Aug 03 [cited 2016
Jul 26]:[21 sheets]. Available from URL: https://www.freece.com/files/classroom/programslides/pdf
LANJUTAN
Fashner J, Gitu AC. Diagnosis and treatment of peptic ulcer disease and H. pylori infection. American
Academy of family Physicians; 2015
PEMBEDAHAN
Indikasi pembedahan adanya ulkus yang
membandel serta adanya komplikasi yang tidak
dapat ditangani dengan konservatif
pembedahan ulkus yang membandel vagotomi
trunkus, vagotomi selektif dan (gastrektomi
parsial) dan diikuti dengan rekonstruksi.
Ulkus gaster gastrektomi parsial dan
anastomosis secara Billorth 1
De Jong W, Sjamsudihajat. Dalam: Sjamsudihajat R, Karnadihrdja W, Prasetyono TOH, editors. Buku ajar ilmu
bedah. Edisi 3. Jakarta: EGC; 2001
KOMPLIKASI
Perdarahan
Obstruksi
Penetrasi atau perforasi
De Jong W, Sjamsudihajat. Dalam: Sjamsudihajat R, Karnadihrdja W, Prasetyono TOH, editors. Buku ajar ilmu
bedah. Edisi 3. Jakarta: EGC; 2001
PROGNOSIS
Anand BS, Katz J. Peptic ulcer disease. [internet] 2015 Jan 09 [cited 2016 Jul 26]:[10 sheets]. Available from
URL: https://www.emedicine.medscape.com/article/181753-overview
TERIMA KASIH