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All Journal Medicina Jurnal Penyakit Dalam Udayana The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Hendra Koncoro

Department of Internal Medicine, Faculty of Medicine, University of Udayana Sanglah Hospital, Denpasar

Author-ID : 299627

Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

Published : 9 Documents Claim Missing Document

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Articles

seorang penderita tuberkulosis diseminata dengan komplikasi penyakit ginjal kronis Koncoro, Hendra; Kandarini, Yenny; Sudhana, Wayan; Widiana, I Gde Raka
Medicina Vol 47 No 3 (2016): September 2016
Publisher : Medicina

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (302.707 KB)

Tuberkulosis diseminata dapat melibatkan berbagai organ dan secara klinis timbul dengan bermacam-macam tanda dan gejala.Penyakit ginjal kronis merupakan salah satu komplikasi yang disebabkan oleh penyebaran hematogenik Mycobacterium tuberculosis ke traktus urogenital. Diagnosis dini dan inisiasi terapi yang tepat merupakan hal penting dalam pencegahan komplikasi lanjut penyakit ini. Dilaporkan sebuah kasus dengan tuberkulosis diseminata yang memperlihatkan keterlibatan paru dan organ ekstra-paru. Kasus ini memperlihatkan tuberkulosis paru, serviks, dan urogenital yang dikonfirmasi dengan pewarnaan sputum basil tahan asam, biopsi serviks, dan biopsi buli buli. Pewarnaan sputum basil tahan asam menunjukkan hasil 3+, sedangkan biopsi serviks dan buli buli menunjukkan radang kronik granulomatosa dengan multinucleated giant cell tipe Langhans. Kadar blood urea nitrogen (BUN) 11 mg/dL dan kreatinin serum 2,58 mg/ dL dengan hidronefrosis ringan kiri pada saat dirawat. Setelah diagnosis ditegakkan, pasien diterapi dengan obat anti-tuberkulosis dan membaik dengan kadar BUN 13,55 mg/ dL dan kreatinin serum 0,9 mg/ dL setelah satu bulan terapi.[MEDICINA.2016;50(3)63-70]

Upper Gastrointestinal Endoscopy as Diagnostic Test for Detection of Gastric Malignancy in Sanglah Hospital Denpasar Nyoman Wibawa, I Dewa; Indrayani, Luh Putulin; Primadharsini, Putu Prathiwi; Koncoro, Hendra
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 1 (2015): VOLUME 16, NUMBER 1, April 2015
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Background: Gastric malignancy is the third most common cause of cancer-related death in the world. Upper gastrointestinal (UGI) endoscopy for detection of gastric malignancy has been used widely in Indonesia. This study aimed to determine the prevalence of gastric malignancy and diagnostic value of UGI endoscopy in detection of gastric malignancy in Sanglah Hospital, Denpasar.Method: A retrospective study on patients undergoing UGI endoscopy in Endoscopy Unit of Sanglah Hospital Denpasar between January 2012 and December 2014 was conducted. Endoscopical and histological diagnosis were documented. The diagnostic test of endoscopic diagnosis were conducted by showing its sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.Results: One thousand and sixty eight patients with upper gastrointestinal symptoms were subjected to endoscopy between January 2012 and December 2014. Of the 1068 cases, 39 patients were suspected for gastric malignant lesions on UGI endoscopy. During the study period, histopathologically-confirmed gastric malignancy was found in 2.72% patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of UGI endoscopic diagnosis for these neoplastic lesions were 100%, 99.04%, 74.36%, 100%, and 99.06%, respectively.Conclusion: The prevalence of gastric malignancy was higher compared to western countries. Endoscopy is important as diagnostic tool in patients with suspicion of gastric malignancy. Greater suspicion in clinical judgment and carefulness in excluding malignancy through one histopathology negative findings need to be done to reduce the number of misdiagnoses of gastric malignancy.

Peptic Ulcer Disease Different Pathogenesis of Duodenal and Gastric Ulcer Wibawa, I Dewa Nyoman; Koncoro, Hendra
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 3 (2015): VOLUME 16, NUMBER 3, December 2015
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Despite decrease frequency of Helicobacter pylori (H. pylori) due to eradication therapy, peptic ulcer disease as a manifestation of this infection is still remain a health burden. Understanding the physiology of gastric acid secretion and its alteration by H. pylori induced inflammation will aid physician in differentiating peptic ulcer disease based on its location. Duodenal ulcer and gastric ulcer disease are two common condition that usually found in peptic ulcer. Recognition of symptoms and its pathogenesis may lead physician to understand the fate of each condition in the future. This article reviews concept of peptic ulcer pathogenesis according to ulcer etiology.

Age and Alarm Symptoms Predict Upper Gastrointestinal Malignancy among Patients with Dyspepsia Koncoro, Hendra; Wibawa, IDN; Suryadarma, IGA; Purwadi, Nyoman; Somayana, Gde; Mariadi, I Ketut
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Background: Upper gastrointestinal (UGI) malignancy is one of the major causes of cancer related death. Endoscopy in dyspeptic patients above 45 years, or those with alarm symptoms may detect this condition. There were only limited data in Indonesia about age and alarm symptoms to predict UGI malignancy. This study was aimed to determine the prevalence of UGI malignancy among dyspepsia patients and to develop a simple clinical prediction model.Method: A cross-sectional study to 390 patients with dyspepsia underwent endoscopy in Endoscopy Unit of Sanglah Hospital Denpasar between July 2012 and June 2013 was conducted. Demography and alarm symptoms were documented. Chi-square and logistic regression test analysis were conducted to analyze variables associated with UGI malignancy.Results: Twenty (5.13%) of 390 patients with dyspepsia had UGI malignancy. Of the 20 patients, 65% were gastric cancer and 30% were esophageal cancer. The mean age was 59 ± 12 years. Variables associated with UGI malignancy were weight loss (OR = 8.2), dysphagia (OR = 6.2), age > 45 years old (OR = 5.6), gastrointestinal bleeding (OR = 5.5), persistent vomiting (OR = 5.4), and anemia (OR = 4.9). Using a simplified rule of age >45 years and the presence of any alarm symptom, sensitivity was 85% and specificity was 67.57%.Conclusions: UGI malignancy was found in 5.13% of patients with dyspepsia who underwent endoscopy. Simple clinical prediction model states that age above 45 years and alarm symptoms may be used as a screening tool to predict UGI malignancy.Keywords: dyspepsia, alarm symptoms, upper GI malignancy, clinical prediction model

A Rare Complication of Acute Appendicitis: Superior Mesenteric Vein Thrombosis Johan, Maisie ME; Setijoso, Rafael Eddy; Koncoro, Hendra
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 3 (2016): VOLUME 17, NUMBER 3, December 2016
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Superior mesenteric vein (SMV) thrombosis caused by acute appendicitis is quite rare nowadays. These conditions occurs secondary to infection in the region drained by the portal venous system. In this case, we report a successfully treated case of SMV thrombosis and liver abscess associated with appendicitis with antibiotics and anticoagulant.Early diagnosis and prompt treatment are basic to a favorable clinical course.

Acute Pancreatitis as a Complication of Choledochal Cyst Wibawa, I Dewa Nyoman; Koncoro, Hendra
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 2, August 2012
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Choledochal cysts (CCs) are rare congenital disorders of the biliary tree which are associated with biliary tract and pancreatic complications. Its etiology is still unknown, but some evidences suggest that CCs are caused by infection during embryogenesis. The laboratory evaluation reveals abnormalities due to pancreatobiliary complications, such as ascending cholangitis, cholecystitis, and pancreatitis. Radiologic examination may delineate the structural abnormalities occured in CCs and confirm the diagnosis. The major mortality is caused by cholangiocarcinoma. This case discussed the diagnosis and treatment of a 20-year-old male with choledochal cyst and its complications. Management consists of therapy on complication and definitive therapy. Keywords: choledochal cyst, acute pancreatitis, cholecystitis

Kadar Resistin Serum Berhubungan Dengan Skor Child-Turcotte Pugh Pada Penderita Sirosis Hati Koncoro, Hendra; Primadharsini, Putu Prathiwi; Mariadi, I Ketut; Somayana, Gde; Suryadarma, I Gusti Agung; Purwadi, Nyoman; Wibawa, I Dewa Nyoman
Jurnal Penyakit Dalam Udayana Vol 1 No 1 (2017): JPD Vol. 1 No.1 2017
Publisher : PAPDI BALI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (617.413 KB)

Latar Belakang: Sirosis hati (SH) sering disertai tingginya resistensi insulin dan kondisi proinflamasi. Resistin yang merupakan suatu adipokin, diketahui memiliki hubungan dengan resistensi insulin dan inflamasi. Studi-studi resistin pada SH memperlihatkan hasil yang bervariasi. Tujuan penelitian ini adalah untuk mencari hubungan kadar resistin serum dengan skor Child-Turcotte Pugh (CTP) pada penderita SH. Metode: Penelitian observasional, studi potong lintang ini dilaksanakan di RSUP Sanglah dari September 2014 sampai dengan Juni 2015 dengan menggunakan 75 pasien sirosis hati sebagai sampel. Kriteria inklusi mencakup pasien sirosis hati tanpa memandang etiologinya dan berusia 12 tahun atau lebih. Variabel yang diperiksa pada penelitian ini yaitu skor CTP (kadar albumin serum, kadar bilirubin total serum, nilai waktu protrombin, kadar international normalized ratio (INR), tanda ascites, tanda ensefalopati hepatikum), kadar C-reactive protein (CRP), dan kadar resistin serum. Hasil: Enam puluh lima persen dari 75 sampel adalah laki-laki dan sisanya perempuan. Sebelas diantaranya (14,7%) adalah kelas CTP A, 31 (41,3%) kelas CTP B, dan 33 (44%) kelas CTP C. Rerata kadar CRP adalah 15,05 Â± 15,86 mg/L. Rerata kadar resistin adalah 23,39 Â± 17,79 ng/mL. Hasil uji korelasi didapatkan korelasi positif yang sedang antara kadar resistin dan skor CTP (r = 0,438; p < 0,001). Korelasi positif sedang juga didapatkan antara CRP dan resistin (r = 0,478; p < 0,001). Simpulan: Kadar resistin memiliki korelasi sedang dengan skor CTP pada pasien SH. Kadar resistin didapatkan lebih tinggi kadarnya pada SH yang berat. Hal ini menunjukkan adanya kondisi inflamasi dan resistensi insulin seiring dengan peningkatan derajat beratnya SH.

Choledocholithiasis during Pregnancy: Multimodal Approach Treatment Philipi, Benny; Koncoro, Hendra; Lesmana, Cosmas Rinaldi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 1 (2016): VOLUME 17, NUMBER 1, April 2016
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Pregnancy is an important risk factor for growth of choledochal stones. Since choledocholithiasis encountered during pregnancy, which is also a possible cause of pancreatitis and cholangitis, may be the reason for serious morbidity and mortality both for the mother and the fetus, it should be treated. In this article, the results and reliability of endoscopic retrograde cholangiopancreatography (ERCP) application on a pregnant woman accompanied with percutaneous biliary procedures are presented. We report a case of 33-year-old woman at 19th week of gestation with cholestatic jaundice due to a common bile duct (CBD) stone managed by endoscopic retrograde cholangiopancreatography (ERCP). The patient had post ERCP pancreatitis which resolved with medical management. Percutaneous cholecystostomy was also performed to control source of infection in the gallbladder. ERCP is the first procedure that will be preferred in the treatment of choledocholithiasis in pregnancy with the right indications provided that proper precautions have been taken. Possible harmful effects of ionized radiation on fetus during fluoroscopy should be minimalized by giving in short periods and low doses.Keywords:

EOSINOPHILIC COLITIS PRESENTING WITH CHRONIC DIARRHEA Koncoro, Hendra; Setijoso, Rafael Eddy; Tambun, Renaningtyas
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 1 (2018): VOLUME 19, NUMBER 1, April 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/191201852-55

Eosinophilic colitis (EC) is a rare disease which characterized by infiltration of eosinophil in colon and peripheral eosinophilia. Other causes of peripheral eosinophilia need to be excluded before assumed EC such as food allergy, inflammatory bowel disease, or parasites. It has bimodal distribution, peaked at neonates and young adult.A 24-year-old man was admitted with abdominal pain and chronic diarrhea. He has no any disease, food, pollen, or drug allergy in his medical history. Leukocyte: 29,000/mm3 (neutrophil: 43.4%, eosinophil: 44.4%, lymphocyte: 8.2%), platelet: 453,000/mm3, total eosinophil: 17,582.1/µL (normal range: 50-300), immunoglobulin E: 1000 IU/mL (normal range < 100 IU/mL) was counted in his blood examination. The colon biopsy was reported as eosinophilic colitis. We applied methylprednisolone 24 mg/day. With this treatment, the patient?s symptoms regressed.EC may involve any part of the gastrointestinal tract. An intense inflammatory infiltrate, consisting predominantly of eosinophils penetrates into one or more layers of the gastrointestinal tract. In 1937, Kaijser described this disorder. EC is classified into mucosal, submucosal or muscular, and serosal types. The endoscopic findings may vary from normal mucosa to frank ulceration. Our patient had chronic diarrhea and peripheral eosinophilia which are typical features of the mucosal types. It should be put in differential diagnosis in patients with chronic diarrhea.

Co-Authors C Rinaldi A Lesmana Gde Somayana I Dewa N Wibawa, I Dewa N I Dewa Nyoman Wibawa I Gde Raka Widiana I Gusti Agung Suryadarma I Ketut Mariadi I Komang WD Putra, I Komang WD IDN Wibawa Johan, Maisie ME Luh Putulin Indrayani, Luh Putulin Nyoman Purwadi Philipi, Benny Putu Prathiwi Primadharsini Setijoso, Rafael Eddy Setijoso, Rafael Eddy Tambun, Renaningtyas Tambun, Renaningtyas Wayan Sudhana Yenny Kandarini

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