Morning Report

Nurfaidah C111 13 060

Ika Fitri C111 13 061
A. Tenri Luwu C111 13 062
Mutmainnah C111 13 063
Nurul Qalby C111 13 064

12 AGUSTUS 2017
Identitas Pasien
Nama : Ny. PB
Umur : 36 tahun
Jenis kelamin : Perempuan
Nomor RM : 811514
Klinis : Ileus Obstruktif
Foto Polos
Abdomen 3
Posisi
1. Udara usus terdistribusi
minimal sampai ke distal
colon.
2. Tampak Ground Glass
Opacity pada rongga
abdomen yang
mendesak loop-loop
usus ke arah central
3. Tidak tampak dilatasi
loop-loop usus,
gambaran herring bone,
dan air fluid level.
4. Kedua psoas line sulit
dinilai, preperitoneal fat
line baik.
5. Tulang-tulang intak

KESAN:
- Ascites
Ascites
Ascites is defined as an abnormal amount of intraperitoneal fluid.

Clinical Presentation: Patients with large volume of ascites can present

with –
Abdominal distension (which may be Painful)
Nausea
Vomiting
Dyspnoea
Peripheral oedema
Patology
Ascitic fluid is traditionally characterised as either:
transudate: thin, low protein count and low specific gravity
exudate: high protein count and specific gravity

More recently, the concept of the serum-ascites albumin gradient has

been shown to be more accurate in classification of the causes of
ascites 5. For the purposes of simplicity however, we maintain the
former classification.
Etiology
Causes of transudative ascites: Causes of exudative ascites:
hepatic cirrhosis peritoneal carcinomatosis
alcoholic hepatitis pancreatitis
heart failure (CHF) abscess
hypoproteinaemia nephrotic syndrome
portal vein thrombosis peritonitis, e.g. tuberculosis
peritoneal dialysis ischaemic bowel
malignancy (~10% of refractory bowel obstruction
ascites) 7, 9
◦ most commonly: breast, ovarian,
endometrial, gastrointestinal
and pancreatic 7
AXR
Detection of intraperitoneal fluid on a plain radiograph requires at least
500 mL to be present.
Plain film findings of ascites include:
diffusely increased density of the abdomen
poor definition of the the soft tissue shadows, such as the psoas
muscles, liver and spleen
medial displacement of bowel and solid viscera (away
from properitoneal fat stripe)
bulging of the flanks
increased separation of small bowel loops
AXR
Differential diagnosis
Consider other causes of intraperitoneal fluid:
physiological: small amount of pelvic fluid may be normal in young
females
haemoperitoneum
chylous ascites
biloma/bile leak
urinoma/urine leak, e.g. from bladder trauma

Sumber: Radiopaedia.org
TERIMA KASIH