Digestive system.

Presentasi berjudul: "Digestive system."— Transcript presentasi:

1 Digestive system

2 Anatomi

3

4 Penyakit sistem digesti:
Oesophagus and Diaphragma Stomach and Duodenum Liver and Biliary system. Pancreas. Spleen Colorectal and anus. Acute Abdomen. Abdominal Hernia.

5

6 Menurut ICD-10 : K00-K14 Diseases of oral cavity and salivary glands K20-K31 Diseases of esophagus, stomach and duodenum K35-K38 Diseases of appendix K40-K46 Hernia K50-K52 Noninfective enteritis and colitis K55-K64 Other diseases of intestines K65-K68 Diseases of peritoneum and retroperitoneum K70-K77 Diseases of liver K80-K87 Disorders of gallbladder, biliary tract and pancreas K90-K95 Other diseases of the digestive system C15-C26 Malignant neoplasms of digestive organs

7 Menurut ICD-10 : K20-K31 Diseases of esophagus, stomach and duodenum Esophagitis Gastro-esophageal reflux disease Other diseases of esophagus Disorders of esophagus in diseases classified elsewhere Gastric ulcer Duodenal ulcer Peptic ulcer, site unspecified Gastrojejunal ulcer Gastritis and duodenitis Functional dyspepsia Other diseases of stomach and duodenum

8 Unspecified abdominal hernia
Menurut ICD-10 : K20-K31 Hernia Inguinal hernia Femoral hernia Umbilical hernia Ventral hernia Diaphragmatic hernia Unspecified abdominal hernia

9 Menurut ICD-10 : K50-K52 Noninfective enteritis and colitis Crohn's disease [regional enteritis] Ulcerative colitis Other and unspecified noninfective gastroenteritis and colitis

10 Menurut ICD-10 : K55-K64 Other diseases of intestines Vascular disorders of intestine Paralytic ileus and intestinal obstruction without hernia Diverticular disease of intestine Irritable bowel syndrome Other functional intestinal disorders Fissure and fistula of anal and rectal regions Abscess of anal and rectal regions Other diseases of anus and rectum Other diseases of intestine Hemorrhoids and perianal venous thrombosis

11 Other disorders of peritoneum
Menurut ICD-10 : K65-K68 Diseases of peritoneum and retroperitoneum Peritonitis Other disorders of peritoneum Disorders of peritoneum in infectious diseases classified elsewhere Disorders of retroperitoneum

12 Alcoholic liver disease Toxic liver disease
Menurut ICD-10 : K70-K77 Diseases of liver Alcoholic liver disease Toxic liver disease Hepatic failure, not elsewhere classified Chronic hepatitis, not elsewhere classified Fibrosis and cirrhosis of liver Other inflammatory liver diseases Other diseases of liver Liver disorders in diseases classified elsewhere K80-K87 Disorders of gallbladder, biliary tract and pancreas K90-K95 Other diseases of the digestive system

13 Menurut ICD-10 : K80-K87 Disorders of gallbladder, biliary tract and pancreas Cholelithiasis Cholecystitis Other diseases of gallbladder Other diseases of biliary tract Acute pancreatitis Other diseases of pancreas Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere

14 Intestinal malabsorption
Menurut ICD-10 : K90-K95 Other diseases of the digestive system Intestinal malabsorption Intraoperative and postprocedural complications and disorders of digestive system, not elsewhere classified Other diseases of digestive system Complications of artificial openings of the digestive system Complications of bariatric procedures

15 Menurut ICD-10 : C15-C26 Malignant neoplasms of digestive organs Malignant neoplasm of esophagus Malignant neoplasm of stomach Malignant neoplasm of small intestine Malignant neoplasm of colon Malignant neoplasm of rectosigmoid junction Malignant neoplasm of rectum Malignant neoplasm of anus and anal canal Malignant neoplasm of liver and intrahepatic bile ducts Malignant neoplasm of gallbladder Malignant neoplasm of other and unspecified parts of biliary tract Malignant neoplasm of pancreas Malignant neoplasm of other and ill-defined digestive organs

16 Penyakit : Kongenital Trauma Infeksi / radang. Neoplasma. Degeneratif

17 Disease Of The Esophagus
G E R D (Gastro Esophageal Reflux Disease) Barret’s Esophagus. Motility Disorder ( Achalasia ect. ) Tumor of the Esophagus. Stricture. Diaphragmatic Hernia.

18 Diseases of the Stomach & Duodenum.
Peptic Ulcer Disease Gastritis and Stress Ulcer Benigne / Malignant Neoplasma Volvulus GERD. Duodenal Diverticle.

19 Achalasia (chalasia = relaxation)
Neuro muscular disorder : piristaltik primer menurun relaksasi sfingter esofagus distal menurun = MEGA ESOFAGUS = kardiospasme Patofisiologi Gangguan plexus myenterik Aurbach ( hk. Cannon ) non cholinergic Chagas disease  parasimpatis (secondary)

20 Karsinoma Esofagus Epidemiologi Patologi diet alkohol merokok
 4% keganasan saluran cerna Patologi 60 % skuamus sel karsinoma, merata pada 1/3 proksimal tengah dan distal esofagus 40% adeno karsinoma terutama distal esofagus

21 Hernia Diafragmatika Kongenital Akuisita traumatik hiatus esofagus

22 Hernia Hiatal Type I Hernia sliding (90%)  GERD
Esofagitis refluks – nyeri dada terutama malam hari waktu tidur (sudut His) regurgitasi X - ray : lambung diatas diafragma (Trendelenburg) Endoskopi : esofagitis Terapi : obat-obat anti asam H2 antagonis Proton pump inhibitor Type II Hernia paraesofageal (5 – 10%) Asimtomatik Gejala obstruksi mekanis Type III Kombinasi

23 Tukak Peptik Perdarahan 20% hematemesis + melena
sering terjadi setelah obat-obat salisilat kortikosteroid dan NSAID 40 % penyebab kematian 75 % cukup terapi medikal Perdarahan ulang  mortalitas meningkat

24 Sindroma Dumping 15 menit setelah makan
Volume plasma menurun  gg. hemodinamik Volume usus kecil meningkat  peristaltik meningkat  diare Palpitasi – tachycardia Kesadaran menurun

25 Karsinoma Lambung Insiden tinggi di: Jepang 54,2% dari † tumor ganas ♂
Eslandia Chili Hawaii Diagnosa dini : Kanker lambung dini Jepang: deteksi dini 1950 (1%) – 1989 (50%)

26

27 Stress Ulcer LESI SUPERFISIAL – MULTIPEL – MUCOSA LAMBUNG
FUNDUS – KORPUS LAMBUNG TRAUMA SYOK BEDAH MAJOR SEPSIS CUSHING ULCER RUDA PAKSA CURLING ULCER LIKA BAKAR PATOFISIOLOGI ? ASAM LAMBUNG ISKEMIA MUKOSA

28 Divertikel Meckel Duktus Omphalo Enterikus Persisten
2 Epid : insiden persen populasi umum laki-laki kali wanita Penyulit pada usia tahun Sering dijumpai kebetulan waktu lapatotomi Patognomonis : vaskularisasi eksklusif  langsung dari arteri mesenterika superior

29

30 Ileitis Terminalis = ENTERITIS REGIONAL = PENY. CROHN (1932)
Radang kronis granulomatik terutama ileum terminalis Patologi : skip area (patchy) pan-enteritis  stenosis/fistel usus Etiologi ? virus – mikroba – alergi Anglo Saxon kongenital (genetik)? Klinis : nyeri – muntah febris – kolik – berat badan menurun – anemia diare tanpa darah mass + fistel usus / perineum X – ray Ba-inloop : penebalan dinding ileum terminalis stenosis – “cobble stone”