Ari F Syam
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Journal : The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Hematochezia in Young Patient Due to Crohn’s Disease Anna Mira Lubis; Marcellus Simadibrata; Dadang Makmun; Ari F Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 2, August 2006
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/72200654-56

Abstract

Crohn’s disease encompasses a spectrum of clinical and pathological patterns, affecting the gastrointestinal (GI) tract with potential systemic and extraintestinal complications. The disease can affect any age group, but the onset is most common in the second and third decade. Lower GI bleeding is one of its clinical features. Surgical intervention is required in up to two-thirds of patients to treat intractable hemorrhage, perforation, obstruction or unresponsive fulminant disease. We reported a case of Crohn’s disease in young male who suffered from severe lower GI bleeding (hematochezia) as the clinical features. Lower GI endoscopy revealed ulceration at the distal ileum surrounded by fibrotic tissue as a source of bleeding and a tumor mass at mesocolon. Upper GI endoscopy was unremarkable. Histopathologyc examination concluded multiple ulceration with chronic ischemic condition, appropriate to Crohn’s disease. The patient underwent emergency surgical intervention (subtotal colectomy and ileustomy), and his condition was improved.   Keywords: hematochezia, young male, Crohn’s disease, surgery
Diagnosis and Management of Barret'ƒs Esophagus Adi Wijaya; Dharmika D; Ari F Syam; Toar JM Lalisang
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 2, August 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/62200542-47

Abstract

Incidence of esophageal adenocarcinoma is increasing in western countries and has poor prognosis due to late diagnosis. Barrett’s esophagus is considered as premalignant lesion in which some of squamous epithelium in distal esophagus has been replaced by metaplastic columnar ephithelium. It occurs as complication of longstanding gastroesophageal reflux. Endoscopic examination is very important for early detection especially in patients with chronic symptoms of gastroesophageal reflux disease (GERD) for more than 5 years. Aggressive antireflux treatment may reduce the risk of esophageal carcinoma. However, no single therapeutic modality had been proven superior compare to others, but until now surgery remains the most popular treatment of choice in the management of Barrett’s esophagus.   Keywords: Barrett’s esophagus,GERD, premalignant lesion, management
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
Abdominal Tuberculosis: Diagnostic and Management Problems Noto Dwimartutie; Iskandar A; Marcellus Simadibrata; Ari F Syam; Ceva W Pitoyo; Andri Sulaiman; Tony Loho
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: 10.24871/71200621-27

Abstract

Abdominal tuberculosis, as one of the manifestations of extrapulmonary tuberculosis, may involve gastrointestinal tract, peritoneum, mesenteric lymph nodes, liver, and also spleen. Most patients have constitutional symptoms of fever, pain, diarrhea, constipation, alternating constipation and diarrhea, weight loss, anorexia and malaise. It also has an insidious course without any specific laboratory, radiological or clinical findings and makes it difficult to diagnosis. Anti tuberculosis treatments with initiation phase for 2 months and continue with continuation phase for 7 months is effective. Steroids may be used to reduce acute inflammation and limit delayed fibrotic complications. We report a male patient with abdominal tuberculosis involving peritoneum, liver, colon, paraaorta lymph nodes, and spleen, which at first suggested as a malignancy. Drug induced hepatitis due to anti tuberculosis drug during treatment was emerged and substituted with other regimen. After given anti tuberculosis treatment and steroid as adjunctive treatment, the clinical condition of patient was improved. Keywords: abdominal tuberculosis, anti tuberculosis treatment, drug induced hepatitis
Colonic Tuberculosis: a high Index of Suspicion Wulyo Rajabto; M Usman SM; Khie Chen; Ari F Syam; Murdani Abdullah; Djumhana A; C Martin Rumende
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 2, August 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/62200555-59

Abstract

Tuberculosis remains to be one of the most common problems in developing countries such as Indonesia. It can involve many organs including gastrointestinal tract. Colonic tuberculosis is an ancient disease and has long been recognized. However, it is sometimes difficult to make early diagnosis due to nonspecific sign and symptoms. In endemic areas, correct diagnoses were made only 50% of the time. Without a high index of suspicion of the disease, it has been rarely diagnosed correctly. We reported a case of colonic tuberculosis in 18 years old female patient with lung tuberculosis.Endoscopic examination showed ulcerative mucosa, ‘halo lesion’, and pseudopolyp while PPD skin test, sputum smear and histopathological examination of endoscopic biopsy revealed negative for tuberculosis infection. The presence of lung tuberculosis had made high index of suspicion of colonic tuberculosis. Standard regimen of antituberculosis therapy was given and the patient showed good clinical response.   Keywords: high index suspicion, colonic tuberculosis