s1 kuliah hepatologi ipdiii

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    HEPATOLOGIHEPATOLOGINASRUL ZUBIRNASRUL ZUBIR

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    PENYAKIT HATIPENYAKIT HATI

    1.1.

    HEPATITIS ( Akut & Kronik )HEPATITIS ( Akut & Kronik )

    2.2. SIROSIS HATISIROSIS HATI

    3.3. KARSINOMA HATIKARSINOMA HATI

    4.4. ASES HATIASES HATI

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    HEPATITIS AK!THEPATITIS AK!T

    "I# $"I# $ PERA"ANGAN HATI YANGPERA"ANGAN HATI YANGERLANGS!NG SE%ARA AK!T KARENAERLANGS!NG SE%ARA AK!T KARENA

    EERAPA SEAEERAPA SEA Trn'i'i $ ori*ont+ & ,-rtik+Trn'i'i $ ori*ont+ & ,-rtik+Etio+oi $ 1. /iru' 0 A00%0"0E0#0G0TTEtio+oi $ 1. /iru' 0 A00%0"0E0#0G0TT

    2. Ototn2. Ototn 3. kt-ri3. kt-ri 4. r'it4. r'it

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    Grn K+inikGrn K+inik

    1.1. St r-ikt-rikSt r-ikt-rik

    G-5+ uu in6-k'i ,iru'G-5+ uu in6-k'i ,iru'

    - 0nor-k'i0 tr+i0+-'u - 0nor-k'i0 tr+i0+-'u i+i0 u+0unt 'i+i0 u+0unt '

    2. St Ikt-rik2. St Ikt-rik

    ikt-ru'0 -to-+i0-noti ikt-ru'0 -to-+i0-noti 3.3.St r-ko,+-'-n'iSt r-ko,+-'-n'i

    't. -n7-un 't. -n7-un

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    P-tn -titi' ( -titi'P-tn -titi' ( -titi'

    rk-r )rk-r )H-titi' AH-titi' A $ AntiHA/$ AntiHA/

    H-titi' H-titi' $$

    H'A0ntiH'0H-A0AntiH-0H'A0ntiH'0H-A0AntiH-0

    H8A 0nti H80"NA H/H8A 0nti H80"NA H/

    H-titi' %H-titi' %$ Anti H%/ 0 RNAH%/$ Anti H%/ 0 RNAH%/

    H-titi' "H-titi' "$ Anti H"/$ Anti H"/

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    Lortoriu $Lortoriu $

    #un'i Hti $

    SGOT( AST) 0

    SGPT (ALT)

    i+iruin

    A+uin 0 +ou+in

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    P-r5+nn H-titi' ,iru'P-r5+nn H-titi' ,iru'

    Sembuh (90%)

    B Kronik (10%)

    Hepatitis kronik

    Hepatitis Sirosis hati

    Akut Kanker hati

    C Kronik (90%)

    Sembuh (10 % )

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    P-n8-n9 Pr-,-nti6P-n8-n9 Pr-,-nti6

    1. /k'in'i -titi'1. /k'in'i -titi'

    H-titi' A H-titi' A

    H-titi' H-titi'

    2. Iuno+ou+in2. Iuno+ou+in

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    P-notn H-titi' kutP-notn H-titi' kut

    1. I'tirt

    2. "i-t $ "H1 "H4

    3. Ototn $

    -torot-ktor

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    H-titi' KronikH-titi' Kronik

    "i6 $ H-titi' -nn -r5+nn"i6 $ H-titi' -nn -r5+nn

    -n7kit +-i ri : u+n-n7kit +-i ri : u+n

    T-riri $T-riri $

    1. H-titi' kronik -r'i't-n1. H-titi' kronik -r'i't-n2. H-titi' kronik +ou+-r2. H-titi' kronik +ou+-r

    3. H-titi' kronik kti63. H-titi' kronik kti6

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    G.K+inik H-titi'G.K+inik H-titi'

    kronikkronikGrn k+inik tik k' 0+-'uGrn k+inik tik k' 0+-'u

    0ikt-rik 0-to-+i0ikt-rik 0-to-+i

    P-r5+nn -titi' +-i : u+nP-r5+nn -titi' +-i : u+n0itni -nn H'A (;) tu Anti0itni -nn H'A (;) tu AntiH%/ (;)H%/ (;)

    HK P-r'i't-n 0+ou+-r tik it-uHK P-r'i't-n 0+ou+-r tik it-ukn k-+inn k+ini' 0 !SG(;) 0PA (;)kn k-+inn k+ini' 0 !SG(;) 0PA (;)HK Akti6 0 -ninktn SGOT9SGPTHK Akti6 0 -ninktn SGOT9SGPT

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    P-nt+k'nn HKP-nt+k'nn HK

    I'tirt 6'- kti6 (HKA)I'tirt 6'- kti6 (HKA)

    Ot

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    E,+u'i H-titi' KronikE,+u'i H-titi' Kronik

    1. H'A ti3 u+n2. H/"NA ti : u+n

    3. !SG ti : u+n

    4. SGOT n SGPT ti 3 u+n=. K-+un k-+un

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    ERIMA KASIH

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    SIROSIS HATISIROSIS HATINASRUL ZUBIRNASRUL ZUBIR

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    "i6ini'i $"i6ini'i $

    P-n7kit ti kroni' 7n itniP-n7kit ti kroni' 7n itni

    -nn rn $-nn rn $

    --n-rti6--n-rti6

    N-kro'i'N-kro'i'

    -'truk'i 'truktur ti-'truk'i 'truktur ti

    '-uo+ou+u''-uo+ou+u'

    '-rt 6iro'i' i6u''-rt 6iro'i' i6u'

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    In'i-nIn'i-n

    %in n Ini 4>?%in n Ini 4>?

    A6rik tiur :.>?A6rik tiur :.>?

    A-rik S-rikt 24?A-rik S-rikt 24?

    Inon-'i 3 > ?Inon-'i 3 > ?

    RS.M."5i+ =:?RS.M."5i+ =:?!ur $ 3@=@ tun ( Inon-'i)!ur $ 3@=@ tun ( Inon-'i)

    :@ tun ( LN):@ tun ( LN)

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    Etio+oiEtio+oi

    Yn 'ti $ BYn 'ti $ B

    #ktor -tio+oi $#ktor -tio+oi $

    H-titi' ,iru' H-titi' ,iru'

    A+koo+ A+koo+

    Nutri'i Nutri'i r'it ( '8i'to'oi'i' ) r'it ( '8i'to'oi'i' )

    Krito-nik Krito-nik

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    K+'i6ik'iK+'i6ik'i

    Mor6o+oi $Mor6o+oi $ 1. Mkronou+-r1. Mkronou+-r

    2. Mikronou+-r2. Mikronou+-r 3. Koin'i3. Koin'i

    K+ini'9-tio+oi $K+ini'9-tio+oi $

    1. Po'tn-krotik 9o't-titi'1. Po'tn-krotik 9o't-titi' 2. Port+ 9+koo+ik9nutri'ion+9L-n-82. Port+ 9+koo+ik9nutri'ion+9L-n-8 3. i+i-r3. i+i-r

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    Grn k+inikGrn k+inik

    StiuStiu$$

    1. Ko-n't1. Ko-n't

    2. "-ko-n't2. "-ko-n't

    Grn k+ini' kit $Grn k+ini' kit $

    1. K-+n '-+ ti1. K-+n '-+ ti2. Hi-rt-n'i ort+2. Hi-rt-n'i ort+

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    Akit k-+n '-+ tiAkit k-+n '-+ ti

    Ikt-ru'Ikt-ru'

    Si-r n-,iSi-r n-,i

    P+r -rit-P+r -rit-

    G7n-8o'tiG7n-8o'ti

    Atro6i t-'ti'Atro6i t-'ti'

    Rut '-k'u+ -rkurnRut '-k'u+ -rkurn

    E-9'it-'E-9'it-'

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    Akit i-rt-n'i ort+Akit i-rt-n'i ort+

    Ko+t-r+Ko+t-r+

    %ut -u8-%ut -u8-

    H--t--'i' -+-nH--t--'i' -+-n

    S+-no-+iS+-no-+i

    /ri'-' -'o6u'/ri'-' -'o6u'-oroi-oroi

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    In8i-n8- o6 H%% in8r-'-' Cit ror-'' o6 % t7-8roni8 -titi'

    nor+ %H L% H%%

    Annu+ in8i-n8- o6 H%%

    @

    nor+

    @.=

    #1

    1.=

    #2

    %H

    3.@

    #3

    >.@

    L%

    3@?

    H%%

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    Li,-r 8irro'i'

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    "ino'i'"ino'i'

    1. Grn k+ini'Grn k+ini'

    2. Rio+oi2. Rio+oi

    3. Eno'koi3. Eno'koi 4. !SG4. !SG

    =. %T'8n=. %T'8n

    :. MRI:. MRI >. P-riton-u'koi>. P-riton-u'koi

    D. io'i ( i'toto+oi)D. io'i ( i'toto+oi)

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    P-nt+k'nnP-nt+k'nn

    1. I'tirt1. I'tirt

    2. "i-t 0 "H9RG2. "i-t 0 "H9RG

    3. Ototn3. Ototn 4. Tinkn ku'u'4. Tinkn ku'u'

    1. - int' ('unt)1. - int' ('unt)

    2. TIPS ( Trn'5uu+ri' intr2. TIPS ( Trn'5uu+ri' intr -ti8 orto'7't-i8 'unt)-ti8 orto'7't-i8 'unt)

    3. Trn'+nt'i ti3. Trn'+nt'i ti

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    Prono'i'Prono'i'

    T-rntun $T-rntun $

    -tio+oi -tio+oi

    Tn k+ini' Tn k+ini'

    K-+inn +ortoriu K-+inn +ortoriu

    H'i+ -notn H'i+ -notn

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    KEGANASANKEGANASAN

    HEPATOILIERHEPATOILIER

    NASRUL UB!R

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    T!MOR HATIT!MOR HATI

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    Tuor HtiTuor Hti

    Tuor ti $ 1. -nin ( ink )Tuor ti $ 1. -nin ( ink )

    2. M+in ( n' )2. M+in ( n' )

    1. Tuor -nin $1. Tuor -nin $

    . Pr-nki $. Pr-nki $

    -to-no -to-no

    8o+nio-no 8o+nio-no

    8urn 8urn

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    b. Tumor vaskulerb. Tumor vaskuler

    " heman#ioma

    " $iman#ioma

    &' umor $ain"$ain " ibroma

    " $ipoma

    " $eimioma

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    2. Tuor Gn'2. Tuor Gn'

    1. Tuor n' ti ri-r ( H-to ) $1. Tuor n' ti ri-r ( H-to ) $ . '-+ ti $ %-to'-+u+-r. '-+ ti $ %-to'-+u+-r

    %8o+nio'-+u+-r%8o+nio'-+u+-r %-to8o+nio%-to8o+nio '-+u+-r'-+u+-r . rinn ikt $. rinn ikt $

    6iro'rko 6iro'rko +i6o +in +i6o +in +-oio'rko +-oio'rko

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    Knk-r HtiKnk-r Hti(kr'ino -to'-+u+-r )(kr'ino -to'-+u+-r )

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    Ei-io+oiEi-io+oi

    T-rut A'i06rikT-rut A'i06rik

    Lki+ki Cnit 3$1Lki+ki Cnit 3$1

    !ur +-i u i A'i n A6rik!ur +-i u i A'i n A6rik

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    Etio+oi $ BEtio+oi $ B

    1. #ktor r-i'o'i'i#ktor r-i'o'i'i

    'iro'i' ti 'iro'i' ti

    -titi' -titi'

    nutri'i nutri'i

    n kr'ino-nik n kr'ino-nik

    -r-it-r0 ++ -r-it-r0 ++

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    Grn k+inikGrn k+inik

    n7-ri -rut knn t' n7-ri -rut knn t'

    -n5o+n -rut knn -n5o+n -rut knn

    -rut un8it -rut un8it

    L- 0+-'u 0 -nurun nor-k L- 0+-'u 0 -nurun nor-k

    'i'i

    -to-+i 0k-r' 0-n5o+20 tik -to-+i 0k-r' 0-n5o+20 tik

    rtrt

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    LortoriuLortoriu

    T-' 6+ ti T-' 6+ ti

    A+6 6-to rot-in (A#P) A+6 6-to rot-in (A#P)

    PI/KAII ( rotroin inu8- PI/KAII ( rotroin inu8-

    ,itK ntoni't

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    Beore *L

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    Ater *L

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    H-to8-++u+r 8r8ino

    (+r- 'i*-)

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    Ri'k #8tor' o6Ri'k #8tor' o6

    H-to8-++u+-r %r8inoH-to8-++u+-r %r8inoH-titi' ,iru' In6-8tion ( H/ )

    H-titi' % ,iru' In6-8tion ( H%/ )A+8oo+

    %irro'i' o6 +i,-r

    A-G-n-r

    Mi'8-++n-ou' #8tor'

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    TREATMENTTREATMENT1. NONS!RGI%AL

    2. S!RGI%AL

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    NONS!RGI%AL (ME"I%AL)NONS!RGI%AL (ME"I%AL)

    1. ETHANOL INTRAT!MOR (EIT) 2. EMOLI INTRA ARTERIAL (EIA) 3. %HEMOTERAPHY INTRA T!MOR

    ( %IT)9TA%I 4. RA"IO #REF!EN%Y ALATION (R#A) =. RA"IOA%TI/E RA"IATION INTRA

    T!MOR ( RRIT) :. GEN THERAPY

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    "ino'i'"ino'i'

    1. Grn k+ini'1. Grn k+ini'

    2. Rio+oi2. Rio+oi

    3. %TS8n3. %TS8n

    4. MRI4. MRI

    =. Anior6i=. Anior6i

    :. !SG:. !SG

    >. io'i>. io'i

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    P-nt+k'nnP-nt+k'nn

    1. I'tirt1. I'tirt

    2. "i-t2. "i-t

    3. Ototn (-i8+)3. Ototn (-i8+) -tno+ intr tuor (EIT) -tno+ intr tuor (EIT)

    Eo+i intr rt-ri+ ( EIA) Eo+i intr rt-ri+ ( EIA)

    Rio 6r-u-n8- +tion Rio 6r-u-n8- +tion 4. Tinkn - $ r-'-k'i4. Tinkn - $ r-'-k'i

    =. Trn'+nt'i=. Trn'+nt'i

    %n-' o6 !S i- o6 tuor urin R#A

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    %n-' o6 !S i- o6 tuor urin R#A

    1 2 3

    4 =

    s s

    1 2 3

    =4

    RA"IO#REF!EN%Y ALATIO

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    RA"IO#REF!EN%Y ALATIO

    HOOKE" ARRAYS

    ELE%TRO"E%ON/ENTIONALMONOPOLARELE%TRO"E

    %OOLE"TIP ELE%TRO"E1.: 8

    (+tion r-)

    Ion ittion i' rou8- Citin t- ti''u-' 'urrounin t- -+-8tro-.Ti' ittion i' 8on,-rt- 7 6ri8tion into -t0 inu8in 8-++u+r -t

    ,i 8ou+ti,- n-8ro'i'.

    Sur-''ion o6 tuor roCt 7 -n-

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    3@@@

    Sur-''ion o6 tuor roCt 7 -n-t-r7 Cit A-no,iru'Eno'ttin

    %ont. Eno'ttin

    1>12D

    1>>122D

    Eno'ttin%ont.

    3

    2@@@

    1@@@

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    S!RGI%AL TREATMENTS!RGI%AL TREATMENT

    1. RESE%TION2. TRANSPLANTATION

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    Prono'i'Prono'i'

    T-rntun $T-rntun $

    'tiu knk-r 'tiu knk-r

    ti- knk-r $ nou+ 0i6u'0 'i6 ti- knk-r $ nou+ 0i6u'0 'i6

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    ASES HATIASES HATI

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    DIFINISIDIFINISI

    S!AT! IN#EKSI HATIS!AT! IN#EKSI HATI

    YANG ER!PA ASESYANG ER!PA ASES

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    ETIOLOGIETIOLOGI

    1. ASES PIOGENIK1. ASES PIOGENIK

    STREPTOKOK!S STREPTOKOK!S

    STA#ILOKOK!S STA#ILOKOK!S

    ++ ++

    2. ASES AM!IK2. ASES AM!IK

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    Grn k+ini'Grn k+ini'

    Skit -rut knn t' Skit -rut knn t'

    "- "-

    H-to-+i H-to-+i

    L-ko'ito'i' L-ko'ito'i'

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    "ino'i'"ino'i'

    1. Grn k+ini'1. Grn k+ini'

    2. Rio+oi2. Rio+oi

    3. !SG3. !SG

    4. %TS8n4. %TS8n

    =. A'ir'i '-'=. A'ir'i '-'

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    USG Abses hati

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    USG Abses hati

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    P-nt+k'nnP-nt+k'nn

    1. I'tirt1. I'tirt

    2. "i-t2. "i-t

    3. Ototn $3. Ototn $ Pio-nik $ ntiiotik Pio-nik $ ntiiotik

    Auik $ ntiu Auik $ ntiu

    M-troni*o+ M-troni*o+4. Tinkn - $ 'ir'i4. Tinkn - $ 'ir'i

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    Prono'i'Prono'i'

    P uun7 ikP uun7 ik

    Ko+ik'i $ 6i'tu+Ko+ik'i $ 6i'tu+

    A'-' ru A'-' ru

    '-'i' '-'i'

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    TERIMA KASIHTERIMA KASIH