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All Journal ISM (Intisari Sains Medis) : Jurnal Kedokteran
Kadek Deddy Ariyanta
Department of Pediatric Surgery, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

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A jejunal atresia type I in newborn: a case report Anak Agung Adi Suryaningrat; Kadek Deddy Ariyanta
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (507.75 KB) | DOI: 10.15562/ism.v11i2.637

Abstract

Background: Intestinal atresia is a common cause of neonatal intestinal obstruction. Jejunal atresia occurs more frequently than duodenal or colonic atresias, while single atresias are most commonly encountered. This case report aims to evaluate the recent management of jejunal atresia type I in newborn.Case Description: We report one case of jejunal atresia types I. A 8-days old newborn was born with signs of upper gastrointestinal obstruction. Bile-stained vomiting was reported on the third day of life. Postnatal abdominal X-ray showed the triple bubble sign. Laparotomy was performed at 9th days of life when it revealed the type of jejunal atresia type 1. The resection procedure on the atresia, such as tapering and end to end anastomosis, was performed. Laparotomy revealed the type I Jejuno-ileal atresia 20 cm from Treitz ligament then resection on the atresias, tapering, and end to end anastomosis was performed. Post-operative, the baby was admitted to NICU with total parenteral nutrition and continued antibiotics due to sepsis.Conclusion: The case was referred to the neonatal intensive care unit post-surgery with a carefully monitored fluid balance, temperature, and sign of sepsis. A definitive antibiotic was given due to sepsis, as well as total parenteral nutrition. 
Cholelithiasis and chronic cholecystitis in a ten-year-old-boy: a case report Carissa Lidia; I Gusti Ngurah Sanjaya Putra; I Putu Gede Karyana; Ni Nyoman Metriani Nesa; I Made Darmajaya; Kadek Deddy Ariyanta
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (881.86 KB) | DOI: 10.15562/ism.v11i3.684

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Background: Cholelithiasis in children is uncommon and challenging to diagnose because the patient is often asymptomatic and the clinical feature doesn't clearly depict cholelithiasis or cholecystitis. This case study aims to describe a rare case of cholelithiasis with chronic cholecystitis in a ten-year-old boy.Case Presentation: A ten-year-old boy presented with umbilical pain, nausea, and emesis. Physical examination showed there is no tenderness in all abdominal quadrants with a negative Murphy sign. Laboratory results revealed elevated white blood cell count 20.42x103/?L, elevated erythrocyte sedimentation rate 47.2 mm/hour, normal liver function tests, urine, and stool analysis. He underwent transabdominal ultrasound twice. The latest transabdominal ultrasound showed cholelithiasis, free fluid around the pelvic region due to suspected visceral organ perforation. Laparoscopic cholecystectomy was performed without complication. The result of pathology anatomy examination was chronic cholecystitis. The patient was discharged 3 days after surgery in good condition. The long-term prognosis of the patient was good.Conclusion: Even though the patient is male with good nutritional status (not obese), the patient was in the mean age that was identified as a key contributor to this disease. Ultrasonography examination is a screening modality that is still an excellent diagnostic tool with 95% accuracy even though it is highly operator dependent. Laparoscopic cholecystectomy is a gold standard for management even in children with decreased pain and shorter lengths of stay in the hospital.
Co-Authors Anak Agung Adi Suryaningrat Carissa Lidia I Gusti Ngurah Sanjaya Putra I Made Darmajaya I Putu Gede Karyana Ni Nyoman Metriani Nesa