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Esophageal Myotomy pada Achalasia Nadhia Khairunnisa; Yusmaidi
Medula Vol 10 No 2 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i2.61

Abstract

Achalasia is a rare esophageal motility disorder that results from decreased or the absence of ganglion-blocking cells in the esophageal myenteric plexus and lower esophageal sphincter (LES). This results in the inability of the LES to relax as well as the dysfunction of the esophagus. Patients usually present with symptoms of dysphagia. Surgical therapy in Achalasia is known as Heller myotomy (Esopageal myotomy), a procedure in which the muscles around the esophagus are opened and cut. Conventional surgery uses a long incision in the chest and abdomen provides a very good result in decresing the symptoms, with a efficacy level from 88% to 95% and lasting for 6 to 10 years. For example, in the case of Mr. Y, 51 years old came with disfagia since approximately 1 year ago. The patient also complained losing weight for 10kg in the past 6 months. The physical examination of the patient are compost mentis. Blood pressure 170/100 mmHg, heart rate 80x / minute, respiratory rate 20x / minute, temperature 37.0oC. Examination of extremities and neuromuscular are normal. At radiological examination, a rontgent was obtained with the appearance of an esophageal dilatation.
Salfingoophorectomy pada Giant Ovarian Mature Cystic Teratoma disertai Hernia Umbilikal Rachmatia Ramadanti; Yusmaidi
Medula Vol 10 No 3 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i3.93

Abstract

Giant ovarian cysts are tumor which have a diameter > 10 cm in radiology or reaching above the umbilicus. Symptoms of tumor are usually asymptomatic, but can cause nonspecific stomach disorders including pain, nausea, and vomiting. In teratomas can be found sebaceous glands, sweat glands, hair follicles, fatty tissue. Investigations can be performed ultrasonography and CT-Sacn. The treatment is performed surgically by laparotomy or laparoscopy. In this case Nn.S, 22 years old came with complaints of an enlarged abdomen since 2 years ago. The physical examination of the patient are compost mentis. Blood pressure 130/100 mmHg, heart rate 105x / minute, respiratory rate 24x / minute, temperature 37.0oC. Examination of the abdomen showed an enlargement of the abdomen equivalent to 9 months gestational age with a 103 cm abdominal circumference, bowel sounds (+) 10x / minute, on percussion tympanic to deaf, found palpation hard palpated, negative tenderness. At CT scan shows that teratomas are quite large in the abdominal cavity which deviates the intrabomen into peripheral organs.
Hernia Inguinalis Permagna: Laporan Kasus Yusmaidi; Wasiatul Ilma
Medula Vol 11 No 1 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i1.174

Abstract

Introduction: Giant inguinal hernia is a rare form of hernia, generally defined as an inguinal hernia those size extends below the midpoint of the inner thigh when standing. The management of this type of hernia uses surgical methods with various techniques. This type of hernia is classified as difficult because it requires returning the contents of the hernia bag into the abdominal cavity which is usually empty so that it can cause intra-abdominal hypertension and compartments syndrome of abdominal. Case: A 90 year old man presented with a complaint of a large lump in the right groin. Other complaints do not exist. Management in this patient was a herniotomy continued with strengthening of inguinal canal trough Bassini technique followed by the McVay procedure. Discussion: There is a classification of this type of hernia. Surgical techniques that can be performed to treat giant inguinal hernia also vary. Conclusion: Giant inguinal hernia is a rare case, requires proper management so that mortality and morbidity do not increase.
Co-Authors Nadhia Khairunnisa Rachmatia Ramadanti Wasiatul Ilma