perempuan berusia 45 tahun menderita anemia et causa

8/17/2019 Perempuan Berusia 45 Tahun Menderita Anemia Et Causa

1/27

PEREMPUAN BERUSIA 45 TAHUN MENDERITA

ANEMIA ET CAUSA GASTRITIS EROSIFA ET

CAUSA OAINS DISERTAI DENGAN DM.Reynaldo

11 2014 25

Pe!"#!"#n$% d&. S'"&o(o PH) S*.PD) M.+e,


2/27

Iden(#(a, Pa,#en

Na!a len$-a* % Ny.S en#, -ela!#n % Pe&e!*'an

Te!*a( / (an$$aI la#& % Se!a&an$/112130 S'-' Ban$,a % aa

S(a(', Pe&-a#nan % Men#-a A$a!a % I,la!

Pe-e&6aan % I"' R'!a Tan$$a Pend#d#-an % SMP

Ala!a( % Sa!"#&o(o RT 05/01 Ma,'- RS% 11 A*l 2017


3/27

Ana!ne,#,

8 % A'(oana!ne,#,) (an$$al% 12 A*l 2017) a!% 10.40

8 Keluhan utama: M'n(a "ea&na !e&a -e#(a!an

,e6a- 4 6a! SMRS

8Pa,#en da(an$ den$an -el'an !'n(a "ea&na !e&a-e#(a!an ,e6a- 4 6a! SMRS. Se"el'!nya *a,#en

!en$el' !'al!'al) dan -e!'d#an !'n(a. Pa,#en

!en$a-' !'n(a d#&a,a-an ,e(ela !a-an. M'n(aan

*a,#en "e,# !a-anan yan$ d#,e&(a# den$an a&na !e&a

-e#(a!an. +#&a-#&a ,e(#a* -al# !'n(a 6'!lanya ,e-#(a&1 $ela, a9'a. Pa,#en !en$a-' BAB no&!al (#da-

"ea&na -e#(a!an.


4/27

8 Sela#n #(' *a,#en 6'$a !en$el' -e*alanya (e&a,a *',#n$.

P',#n$ yan$ d#&a,a-an ,e(ela *a,#en !'n(a dan *a,#en!en$a(a-an ,e*e&(# !elayan$. Pa,#en 6'$a !e&a,a-an le!a,

*ada ('"'nya ,e&(a adanya nye *ada *e&'( "a$#an 'l' a(#.

Nye (e&,e"'( d#&a,a-an *ada ,aa( *a,#en d#&a,a (ela( !a-an)

(e(a*# ,e(ela !a-an) nye *ada 'l' a(# (#da- !en$#lan$.

Pa,#en !en$a-' (#da- ,'-a !en$-o,'!,# 6a!'6a!'an)(e(a*# 2 !#n$$' (e&a-#& #n# *a,#en ,e(#a* a !en$-o,'!,#

o"a( an(# nye yan$ d#"el# ,end# d# a*o(#- 'n('-

!en$#lan$-an nye *ada -a-# *a,#en (an*a &e,e* do-(e&.

8Hal #n# "a&' d#&a,a-an *a,#en *e&(a!a -al#nya) *a,#en(#da- *e&na !ende(a ,a-#( #n$$a !'n(a "ea&na !e&a

-e#(a!an ,e"el'!nya.

8 RPD% D#a"e(e, :;


5/27

R#aya( +el'a&$a

H'"'n$anU!'&

:Ta'n <en#, +ela!#n +eadaan +e,ea(an

Penye"a"

Men#n$$al

+a-e- =a-#la-# Men#n$$al S'da ('a

Nene- Pe&e!*'an Men#n$$al S'da T'a

Aya =a-#la-# Men#n$$al S'da T'a

I"' Pe&e!*'an Men#n$$al S'da T'a

Sa'da&a 50 (a'n Pe&e!*'an Sea(

Ana-ana- 2 (a'n =a-#la-# Sea(

25 (a'n =a-#la-# Sea(


6/27

8 Ana!ne,#, S#,(e!

8 A"do!en% M'al dan !'n(a da&a

8 Be&a( "adan &a(a&a(a :+$< % 5 -$8 Be&a( (e&(#n$$# -a*an :+$< % 70 -$

8 Be&a( "adan ,e-a&an$ :+$< % 5 -$


7/27

Pe!e-,aan F#,#-

8 T#n$$# "adan % 154 >!

8 Be&a( "adan % 5 -$

8 +eadaan '!'! % (a!*a- ,a-#( n$an

8 Te-anan da&a % 120/0 !!H$

8 Nad# % 10 ?/!en#(

8 S'' % )2@ C

8 Pe&na*a,an :F&e-'en,# dan (#*e< % 20 ?/!en#() a"do!#no(o&a-al

8 +eadaan $## % Ba#-

8 +e,ada&an % CM

8 S#ano,#, %

8 Ede!a '!'! %

8 Ha"#(', %

8 Ca&a "e&6alan % no&!al

8 Mo"#l#,a,# :A-(# / Pa,#< % a-(#

8 U!'& !en'&'( (a-,#&an *e!e-,a % 50 (a'n


8/27


9/27


10/27

Pa&'*a&' De*an Bela-an$

In,*e-,#

+# ,#!e(, ,aa( ,(a(#, dan d#na!#,) (#da-

ada &e(&a-,# ,ela #$a.

,#!e(, ,aa( ,(a(#, dan d#na!#,)

(#da- ada &e(&a-,# ,ela #$a.

+anan ,#!e(, ,aa( ,(a(#, dan d#na!#,) (#da-

ada &e(&a-,# ,ela #$a.

,#!e(, ,aa( ,(a(#, dan d#na!#,)

(#da- ada &e(&a-,# ,ela #$a.

Pal*a,#

+# T#da- ada &e(&a-,# ,ela #$a) "en6olan

:


11/27

an('n$

In,*e-,#I>(', >o&d#, (#da- (e&l#a(

Pal*a,#I>(', >o&d#, (e&a"a *ada ,ela #$a 45 l#nea !#d>la#>'la, -#

Pe&-',#

Ba(a, -anan% ,ela #$a 2 l#nea ,(e&nal#, -anan

Ba(a, a(a,% ,ela #$a 2 l#nea ,(e&nal#, -#

Ba(a, -#% ,ela #$a 5) l#nea !#d>la#>'la, -#

A',-'l(a,#

B III no&!al) &e$'le&) !'&!'& :


12/27

Pe!"'l' Da&a

8 A&(e Te!*o&al#, % Te&a"a *'l,a,#

8 A&(e +a&o(#, % Te&a"a *'l,a,#

8 A&(e B&a-#al#, % Te&a"a *'l,a,#

8 A&(e Rad#al#, % Te&a"a *'l,a,#8 A&(e Fe!o&al#, % Te&a"a *'l,a,#

8 A&(e Po*l#(ea % Te&a"a *'l,a,#

8 A&(e T#"#al#, Po,(eo& % Te&a"a *'l,a,#

8 A&(e Do&,al#, Ped#, % Te&a"a *'l,a,#


13/27

A"do!en

8 Inspeksi % *e&'( (#da- !e!"'n>#() (#da- ada "en6olan) (#da-

(a!*a- *e!"'l' da&a -ola(e&al) e&n#a) ,(ae dan $e&a-

*e,(al(#- ',', (#da- (e&l#a(.

8 Palpasi

8 D#nd#n$ *e&'(% nye (e-an *ada 'l' a(#

8 Ha(# % (#da- ada *e!"e,a&an

8 =#!*a % (#da- ada *e!"e,a&an

8 G#n6al % "allo(e!en :< dan "#!an'al :<

8

8 Perkusi % (#!*an#) ,#(#n$ d'llne,, :


14/27

An$$o(a $e&a-


15/27


16/27

Pe!e-,aan =a"o&a(o'!

8 =a" CBC 11 A*l 2017

Hemoglobin 6.4 g/dL 11.7 1!.!

Leukosit 3.2 10/'= 4.0 10.0

Hematokrit 20 5 4"ritrosit 2. 107/'= .0 5.20

#rombosit 13 10/'= 150 400

$%& = 0 100

$%H 2 *$ 27 4

$%H% 4 $/d= 2 7

'ula (arah )e*aktu 221 !$/d= 0 150+reum 0.2 !$/d= 50

Kreatinin 1.3 !$/d= 0.450.5


17/27

Pe!e-,aan E+G

R#(!e ,#n', den$an &e-'en,# deny'( 6an('n$ 100?/!en#( S#n', Ta-#-a&d#


18/27

Fo(o To&a?

8 +e,an%

8 Co& (a- !e!"e,a&

8 Ta- (a!*a- -ela#nan *ada *'l!o


19/27

Re,'!e8 Seo&an$ an#(a "e&',#a 45 (a'n da(an$ den$an -el'an

!'n(a "ea&na !e&a -e#(a!an ,e6a- 4 6a! SMRS.M'n(a ,e"anya- d'a -al# dan -'&an$ le"# ,e"anya- 1

$ela, a9'a. Sela#n #(' *a,#en 6'$a !e&a,a-an !'al

,e"el'!nya dan *',#n$. Sela#n #(' *a,#en 6'$a !e&a,a-an

"adan yan$ (e&a,a le!a, dan nye *ada 'l' a(#. Pa,#en

6'$a !en$-o,'!,# o"a( an(# nye yan$ d#"el# d# a*o(#- (an*a

&e,e* da do-(e&.

8 Pada *e!e-,aan (anda (anda #(al TD% 120/0 !!H$) Nad#%

10?/!en#() Naa,% 20?/!en#() S''% )2oC. Pe!e-,aan

#,#- d#da*a(-an adanya >on6'n(#a ane!#, ;/;) a(&o# o(o(('n$-a# -anan dan -#) dan nye (e-an *ada 'l' a(#.

8 Pe!e-,aan *en'n6an$ d#da*a(-an n#la# H" 7)4$/d=) H( 20)

E(&o,#( 2. 107/'=) GDS 221 !$/d=) '&e'! 0.2 !$/d=)

-&ea(#n#n 1.3 !$/d=.


20/27

Ma,ala

8 He!a(e!e,#,

8 Nye 'l' a(#

8 Con6'(#a Ane!#,

8 H#*e&$l#-e!#a


21/27

Pen$-a6#an dan Ren>ana Ta(ala-,ana

8 Hematemesis

8 Pa,#en da(an$ den$an -el'an !'n(a "ea&na #(a!. a&na #(a! !e&'*a-an

*e&(anda adanya *e&da&aan d# ,al'&an *en>e&naan. Pa,#en 6'$a !e!#l#-#

aya( ,e"el'!nya !en$-o,'!,# o"a( an(# nye yan$ d#"el# ,end# d# a*o(#-

,ela!a -'&an$ le"# 2 !#n$$' dan d#-o,'!,# ,e(#a* a (an*a &e,e* da do-(e&.

8 Ren>ana D#a$no,(#- %8 Endo,-o*#

8 Ren>ana Pen$o"a(an %

8 C'># =a!"'n$ den$an a#& d#n$#n !elal'# NGT

8 S'-&ala( ,y&'* 0>>/6a!

8 A,a! (&a-ne,a!a( 250!$/76a!

8

8 Ren>ana Ed'-a,# %

8 Hen(#-an -o,'!,# o"a( an(# nye

8 I,(#&aa( (o(al

8 D#e( !a-anan l'na-) >a"a#


22/27

8 ,-eri +lu Hati

8 Pa,#en !e&a,a-an nye *ada 'l' a(# ,e(ela *a,#en

!'n(a!'n(a. Pa,#en !en6ela,a-an nye *ada 'l'

a(#nya ,e*e (e&(','- (','- dan (#da- !en6ala&. Pa,#en

6'$a !en6ela,-an) *ada ,aa( nye d# 'l' a(#) *a,#en

!en>o"a 'n('- !a-an a$a- nye *ada 'l' a(#nya

"e&-'&an$) (e(a*# ,e(ela !a-an) nye *ada 'l' a(#

(e&,e"'( (e(a* d#&a,a-an dan (#da- !e!"a#-.

8 Ren>ana d#a$no,(#-%8 Endo,-o*#

8 Ren>ana Pen$o"a(an%

8 O!e*&aole In6 1 $&/12 6a!


23/27

8 %onutia Anemis

8 Pada *a,#en *ada ,aa( *e!e-,aan #,#- d#da*a(-an

>on6'(#a yan$ ane!#, *ada !a(a -anan dan -#. Hal #n#

!enanda-an adanya *e&da&aan yan$ ,edan$ (e&6ad#)

,e#n$$a *ada >on6'(#a *a,#en (e&l#a( ane!#,.

Pe&da&aan yan$ d#!a-,'d d#,#n# adala adanya 'l-',

*ada $a,(e& *a,#en yan$ d#a-#"a(-an ole -o,'!,#

OAINS) ,e#n$$a *ada !'n(a *a,#en yan$ ,'da

"e&>a!*'& den$an a,a! la!"'n$ a-an "ea&na-e#(a!an.

8 Ren>ana *en$o"a(an%

8 T&an,',# 2 -ol PRC


24/27

8 Hiperglikemia

8 Pada *e!e-,aan $l'-o,a d#da*a(-an *e!e-,aan

$l'-o,a da&a ,ea-(' yan$ !ele"## "a(a, no&!al dan

*ada *e!e,-aan #,#- d#da*a(-an adanya a(&o# *ada

('n$-a# -anan dan -# *a,#en.

8 Ren>ana *en$o"a(an%

8 Noo&a*#d ? 4'n#(


25/27

8 Kesimpulan

8 Pe&e!*'an "e&',#a 45 (a'n !ende(a ane!#a e( >a',a

$a,((#, e&o,#a e( >a',a OAINS d#,e&(a# den$an D#a"e(e,

Mell#(',.

8 Prognosis:

8 Ad #(a! % D'"#a ad "ona!

8 Ad 'n$,#ona! % D'"#a ad "ona!

8 Ad ,ana(#ona! % D'"#a ad "ona!


26/27

10 April 2163 am 27.22

)

5 +eadaan '!'! % (a!*a- ,a-#( ,edan$

+e,ada&an % >o!*o, !en(#,

Te-anan da&a % 10/0 !!H$) Nad# % 4?/!en#() F&e-'en,# Na*a, % 20?/!en#() S'' % 7)2 oC

Pe!e-,aan #,#- %

Con6'(#a ane!#, /

an('n$ % M'&!'& :


27/27

)

5 +eadaan '!'! % (a!*a- ,a-#( n$an

+e,ada&an % >o!*o, !en(#,

Te-anan da&a % 140/30 !!H$) Nad# % 2?/!en#() F&e-'en,# Na*a, % 20?/!en#()

S'' % 7)7 oC

Pe!e-,aan #,#- %

Con6'(#a ane!#, /

an('n$ % M'&!'& :

perempuan berusia 45 tahun menderita anemia et causa

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