Ikterus Obstruktif

Iswadi Iswadi

doi:10.37287/jlh.v6i2.5802

Iswadi Iswadi Universitas Kristen Satya Wacana

DOI: https://doi.org/10.37287/jlh.v6i2.5802

Keywords: hipertensi, ikterus obstruktif, meteorismu, sindrom mirizzi, tumor periampullary

Abstract

Ikterus adalah perubahan warna kekuningan pada kulit dan mukosa akibat peningkatan kadar bilirubin dalam plasma. Berdasarkan penyebabnya, ikterus dibagi menjadi tiga jenis: pre-hepatik, hepatic/intrahepatic, dan hepatic/ekstrahepatic. Ikterus obstruktif terjadi akibat obstruksi bilier, yang dapat disebabkan oleh kondisi seperti koledocholithiasis, kanker pankreas, dan pankreatitis. Penelitian ini menggunakan metode studi kasus untuk menggali kondisi klinis seorang pria berusia 61 tahun mengalami gejala ikterus obstruktif, nyeri perut, dan kesulitan BAB. Diagnosis awal mencakup ikterus obstruktif, Sindrom Mirizzi, dan tumor periampullary, dengan kondisi meteorismus. Penatalaksanaan melibatkan pemberian cairan infus, analgesik, serta terapi untuk hipertensi portal dan pencegahan infeksi. Diagnosis diferensial, seperti tumor periampullary, penting untuk memastikan diagnosis. Penanganan melibatkan prosedur bedah dan endoskopi, dengan perhatian pada pencegahan komplikasi dan pengaturan cairan tubuh. Tujuan utama adalah meredakan gejala dan mendukung pemulihan pasien.

References

Atrri, B. L., Saini, S., & Kaur, H. (2016). Obstructive jaundice: Its etiological spectrum and radiological evaluation by magnetic resonance cholangiopancreatography. Medical Journal of Dr. D.Y. Patil University, 9(3), 298–303. https://doi.org/10.4103/0975-2870.182506

Baghel, K., Raj, S., Awasthi, I., Gupta, V., Chandra, A., & Srivastava, R. N. (2013). A comparative analysis of nasogastric and intravenous fluid resuscitation in patients with malignant obstructive jaundice prior to endoscopic biliary drainage. North American journal of medical sciences, 5(9), 523–528. https://doi.org/10.4103/1947-2714.118932

Chen, H., Siwo, E. A., Khu, M., & Tian, Y. (2018). Current trends in the management of Mirizzi Syndrome: A review of literature. Medicine, 97(4), e9691. https://doi.org/10.1097/MD.0000000000009691

Fajrian, F. M. (2020). Enzim Transferase dengan Bilirubin Total Penderita Ikterus Obstruktif. Jurnal Ilmiah Kesehatan Sandi Husada, 11(1): pp 176-182. DOI:10.3516/jiskh.v10i2.240.

Fazeny, F. A.O. (2020). Ikterus Obstruktif Pada Penderita Tumor Pankreas. Jurnal Ilmiah Kesehatan Sandi Husada, Vol.11(1): 197-204. DOI: 10.35816/jiskh.v10i2.249

Fiestana, E. (2024). Laporan Kasus: Pankreatitis Akut. Journal of Language and Health, 5(3), 1463-1470. https://doi.org/10.37287/jlh.v5i3.4476

Gleeseon, F., Noble, S. (2015). Orphan symptoms in palliative care. Medicine, Vol. 43 (12): 730 – 735. DOI: https://doi.org/10.1016/j.mpmed.2015.09.016.

Koo, J. G. A., Tham, H. Y., Toh, E. Q., Chia, C., Thien, A., & Shelat, V. G. (2024). Mirizzi Syndrome—The Past, Present, and Future. Medicina, 60(1), 12. https://doi.org/10.3390/medicina60010012

Kruis, T., Güse-Jaschuck, S., Siegmund, B., Adam, T., & Epple, H. J. (2020). Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis. BMC gastroenterology, 20(1), 65. https://doi.org/10.1186/s12876-020-01201-6

Lacerda, P. de S., Ruiz, M. R., Melo, A., Guimarães, L. S., Silva-Junior, R. A. da, & Nakajima, G. S. (2017). Mirizzi syndrome: A surgical challenge. Arquivos Brasileiros de Cirurgia Digestiva, 30(2), 1–4. https://doi.org/10.1590/0102-6720201700020011

Li, L., Zinger, J., Sassen, S.D.T. et al. (2024). The relation between inflammatory biomarkers and drug pharmacokinetics in the critically ill patients: a scoping review. Crit Care 28, 376. https://doi.org/10.1186/s13054-024-05150-4

Liu, J., Qu, J., Chen, H., Ge, P., Jiang, Y., Xu, C., Chen, H., Shang, D., & Zhang, G. (2021). The pathogenesis of renal injury in obstructive jaundice: A review of underlying mechanisms, inducible agents and therapeutic strategies. Pharmacological research, 163, 105311.

Martins, L. E., & Kamenicek, A. (2014). Mirizzi syndrome: A surgical challenge. Arquivos Brasileiros de Cirurgia Digestiva, 27(2), 147–150. https://doi.org/10.1590/S0102-67202014000200015https://doi.org/10.1016/j.phrs.2020.105311

Mokrani, D., Chommeloux, J., Pineton de Chambrun, M. et al. (2023). Antibiotic stewardship in the ICU: time to shift into overdrive. Ann. Intensive Care 13, 39. https://doi.org/10.1186/s13613-023-01134-9

Molfino, A., Amabile, M. I., Monti, M., & Muscaritoli, M. (2017). Omega-3 polyunsaturated fatty acids in critical illness: Anti-inflammatory, proresolving, or both? Oxidative Medicine and Cellular Longevity, 2017, 5987082. https://doi.org/10.1155/2017/5987082

Morales Junior, R., Telles, J. P., Kwiatkowski, S. Y. C., Juodinis, V. D., de Souza, D. C., & Santos, S. R. C. J. (2023). Pharmacokinetic and pharmacodynamic considerations of antibiotics and antifungals in liver transplantation recipients. Liver Transplantation, 29(1), 91–102. https://doi.org/10.1002/lt.26517

McKone, Elizabeth L. et al. (2023). 64-Year-Old Female With Right Upper Quadrant Pain and Jaundice. Mayo Clinic Proceedings, Volume 98, Issue 6, 927 - 932.

Messmer, A. S., Zingg, C., Müller, M., Gerber, J. L., Schefold, J. C., & Pfortmueller, C. A. (2020). Fluid Overload and Mortality in Adult Critical Care Patients-A Systematic Review and Meta-Analysis of Observational Studies. Critical care medicine, 48(12), 1862–1870. https://doi.org/10.1097/CCM.0000000000004617

Pavlidis, E. T., & Pavlidis, T. E. (2018). Pathophysiological consequences of obstructive jaundice and perioperative management. Hepatobiliary & pancreatic diseases international : HBPD INT, 17(1), 17–21. https://doi.org/10.1016/j.hbpd.2018.01.008

Ramadani, R. W.N., Putri, N. E., Amalia, A. A. Hubungan Kadar Gula Puasa Dengan Kadar Kreatinin Pada Pasien Diabetes Melitus Selama 1 Sampai 3 Tahun. Jurnal Kesehatan Tambusai, 5(3). https://doi.org/10.31004/jkt.v5i3.33211

Rousseau, A. F., & Martindale, R. (2024). Nutritional and metabolic modulation of inflammation in critically ill patients: a narrative review of rationale, evidence and grey areas. Annals of intensive care, 14(1), 121. https://doi.org/10.1186/s13613-024-01350-x

Sathyamurthy, A., Choudhary, A., Ng, D., Okponobi, S., Diaz-Arias, A., Grewal, A., & Hammoud, G. M. (2013). Obstructive jaundice due to a rare periampullary tumor. World journal of gastrointestinal oncology, 5(10), 195–197. https://doi.org/10.4251/wjgo.v5.i10.195

Tigabu, B. M., Davari, M., Kebriaeezadeh, A., & Mojtahedzadeh, M. (2018). Fluid volume, fluid balance and patient outcome in severe sepsis and septic shock: A systematic review. Journal of critical care, 48, 153–159. https://doi.org/10.1016/j.jcrc.2018.08.018

Yang, Z., Shi, Z., & Song, W. (2024). How much is too much?: A retrospective causal analysis of the 7-day fluid balance for septic critical care patients. Medicine, 103(52), e40733. https://doi.org/10.1097/MD.0000000000040733

Yusmadi, Rafie, R., Permatasari, A. (2020). Karakteristik Pasien Ikterus Obstruktif Et Causa Batu Saluran Empedu. Jurnal Ilmiah Kesehatan Sandi Husada, 11(1): pp 328-333. DOI: 10.35816/jiskh.v10i2.277.