USUS
Definisi
• Palpasi
– Sausage mass – Intussusception
– Segmen bowel distensi
– Tender – direct / rebound
– Guarding & rigidity – peritonitis
Pemeriksaan Fizikal (samb..)
• Perkusi
– Tampanic
• Rektum
– Kesan intussusception, pelvic mass, rectal
carcinoma
• Auskaltasi
– Bowel sound
• hiperaktif
• Sunyi - paralytic ileus
Investigasi
• Darah
– Hb, FBC, BUSE, GXM
• X-ray
– Plain abdomen –
erect/supine
– Chest x-ray
• Barium enema
• CT scan
• ECG
Diagnosis Perbezaan
• Ac Cholecystitis
• Ac Appendicitis
• Perforated Peptic Ulcer (PGU)
• Ac Pancreatitis
Komplikasi
• Dehidrasi
• Renjatan
• Perforasi
• Peritonitis
• Infeksi
• Gangrene of bowel
Pengurusan
1. Rehatkan pesakit
2. Beri kan IV drip NaCl
3. Gastric aspiration – kosongkan usus
4. Berikan Oksigen – jika pt alami sesak nafas
5. Ambil vital sign
6. Lakukan Ix- blood, x-ray
7. Nil by mouth (NBM)
8. Berikan analgesic injection – IM Diclofenac sodium 75mg –
jika pt sakit (utk adult sahaja)
9. Inj. Antibiotik IV Ampicillin 500 mg 6 hourly jika
Penyumbatan disebabkan oleh jangkitan bakteria (child
bwh 10 thn dose : ½ dose dewasa)
10. Admit pt ke ward for pre –op preparation &
LAPAROTOMY