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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Arman A Abdullah
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Medicine & Pharmacology

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Management of Complicated Colonic Diverticulosis Ariadi Humardani; Ari F Syam; Murdani Abdullah; Ibrahim Basyir; Arman A Abdullah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 1, April 2006
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/71200611-15

Abstract

Prevalence of diverticular disease has been increasing worldwide in concert with the development of industrial era and the alteration of diet pattern to low dietary fiber. Mean age of patients is 60 years; peak incidence at age more than 50 years, 20% less than 50 years, 2-8% less than 40 years. About 50 - 90% of diverticular disease are left-sided especially sigmoid, while in Asian people are mostly right sided. The usual complaint of patient is abdominal pain. Complications that may occur due to diverticulosis are diverticulitis, abscess, fistula, obstruction and bleeding. The presence of complicated diverticulosis can be evaluated by plain X-rays, CT-scan, barium with contrast, ultrasonography and colonoscopy in addition of laboratory examination. The management of complicated diverticulosis usually consists of combination of medical therapy and surgery. Proper and immediate treatment will influence the prognosis of patients.   Keywords: diverticular diseases, diverticulitis, abscess, fistula, obstruction, bleeding
Diagnostic Approach and Treatment of Choledocholithiasis Indah Gianawati; Ali Sulaiman; L A Lesmana; Toar JM Lalisang; Arman A Abdullah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 2, August 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/52200471-75

Abstract

Choledocolithiasis may cause acute cholangitis which is life-threatening condition. It has non specific clinical signs from mild to severe condition such as septicemia. Diagnostic and treatment modalities had developed a great deal recently. Therapeutic options include endoscopic retrograde cholangio pancreatography (ERCP),common bile duct exploration (CBDE), laparoscopic CBDE and stone retrieval. The important thing is to choose the appropriate method for each patient. We reported a case of choledocolithiasis in 40 years old, male patients who was clinically diagnosed as acute cholangitis. Diagnostic approach to find the etiology was done. Abdominal USG and CT were performed and showed multiple stones in gallbladder and intrahepatic biliary duct, suspected mass at caput of the pancreas and hepatomegaly. The ERCP showed dilatation of intra and extra hepatic biliary ducts with multiple stone in common bile duct (CBD), hepatic duct and gallbladder. The stent was placed for biliary drainage. The patient underwent cholecystectomy per laparoscopy, but further evaluation of the cholangiography still showed the presence of stones in intrahepatic biliary duct. Laparotomy exploration of CBD was done and it revealed multiple stones and dilatation of distal CBD. Surgical treatment selected for this case was choledocojejunostomy. Keywords: Choledocolithiasis, CBD, diagnostic approach
Co-Authors Ali Sulaiman Ali Sulaiman Ari F Syam Ariadi Humardani Ibrahim Basyir Indah Gianawati L A Lesmana Murdani Abdullah Murdani Abdullah Toar JM Lalisang Toar JM Lalisang