Chudahman Manan
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Current Treatment of Gastroesophageal-Esophagitis Reflux Disease Chudahman Manan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 3, December 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/23200131-34

Abstract

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Management of Upper Gastrointestinal Bleeding due to NSAID Gastropathy that is Unresponsive to Ranitidine Lusy Erawati; Sayid Ridho; Ginova Nainggolan; Ari Fahrial Syam; Chudahman Manan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, ISSUE 2, August 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/42200359-63

Abstract

Non steroidal anti-inflammatory drugs (NSAIDS) are now commonly used in clinical practice. On the other hands, this drug could result severe complication such as bleeding and perforation. In such condition, proton pump inhibitor can be used to stop bleeding than H2 antagonists. We reported one cases of upper gastrointestinal bleeding due to NSAID gastropathy that was unresponsive to Ranitidine. The treatment was suitable to proton pump inhibitor that could overcome upper gastrointestinal bleeding.
Pathogenesis in Portal Hypertensive Gastropathy Due to Liver Cirrhosis Loli J Simanjuntak; Chudahman Manan; Marcellus Simadibrata; Rino A Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 3, December 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/53200495-101

Abstract

The recent advances of endoscopic examination had proven that source of upper gastrointestinal bleeding in liver cirrhosis is not always caused by esophageal varices rupture but also gastric mucosal lesion. The prevalence of gastric ulcer in patients with liver cirrhosis is higher than healthy individuals. Imbalance of defensive and aggressive factors of gastric mucosa may involve in development of portal hypertensive gastropathy (PHG). Several studies reported hemodynamic changes associated wuth portal hypertension causing decreased mucus layer thickness as one of mechanism of PHG. Other etiologic factors of PHG were hypoacidity, hypergastrinemia, reduced hexosamin concentration, mucus metabolic function associated with decreased prostaglandin E2 (PGE2), and increased nitric oxyde (NO) which had caused mucus wall thickness changes. Gastric mucus damage induced by portal hypertension has important role in the pathogenesis of gastric ulcer in liver cirrhosis. Keywords: Pathogenesis, PHG, liver cirrhosis
Identification and Stenting of Malignant Obstructive Jaundice : Determining the Success Rates of ERCP Budi Tan Oto; Achmad Fauzi; Ari Fahrial Syam; Marcellus Simadibrata; Murdani Abdullah; Dadang Makmun; Chudahman Manan; Abdul Aziz Rani; Daldiyono Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (245.041 KB) | DOI: 10.24871/131201219-22

Abstract

Background: Malignant and benign lesions may cause obstructive jaundice. The treatment of these conditions includes biliary stenting drainage, percutaneous transhepatic biliary drainage (PTBD), or surgical procedures. In advanced malignant jaundice, stent placement often turns out to be difficult. The aim of this study was to determine the success rates of malignant obstructive jaundice detection utilising endoscopic retrograde cholangiopancreatography (ERCP) and its stent placement procedure. Method: We conducted a retrospective study in 139 patients who undergone ERCP in Cipto Mangunkusumo Hospital between October 2004 and July 2008. Data was analyzed descriptively with SPSS version 17.0. Results: Of 139 study subjects, 131 (94.2%) of them had clinical obstructive jaundice (direct bilirubin indirect bilirubin level). There were 73 (55.7) male patients, with age range of 20-84 years. Among 114 patients with identified cause of obstruction, 57 (50%) patients had undergone stent placement; however, only 32 (56.1%) patients had successful stent placement. Our descriptive analysis showed that age and sex did not affect the stent success rates, and malignancy was showed to be a factor of stent failure. Conclusion: ERCP appears to be reliable enough for identifying the cause of obstructive jaundice in most patients. In this study, the achieved success rate of stent placement is more than 50%. Moreover, such rate is lower in the malignant obstructive jaundice than the non-malignant counterparts. Papillary carcinoma is the most frequent cause of malignant obstructive jaundice. Keywords: ERCP, obstructive jaundice, stenting, malignancy
Upper Gastrointestinal Abnormalities in Esophagogastroduodenoscopy Examination: Descriptive Study in PSUPAU Endoscopic Unit Julwan Pribadi; Sedijono Sedijono; Suryantini Suryantini; Marcellus Simadibrata; Ari Fahrial Syam; Murdani Abdullah; Achmad Fauzi; Dadang Makmun; Chudahman Manan; Daldiyono Daldiyono; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 3, December 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/93200882-85

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Background: The Endoscopy Unit of Indonesian Air Force Central Hospital Dr. Esnawan Antariksa, Jakarta, Indonesia, has just been established in late 2004 and it is still in developing process. This study was aim to depict the profile of patients who underwent esophagogastroduodenoscopy procedure in the unit. Method: This study was a retrospective study that analyzed data in endoscopic registry of patients who underwent esophagogastroduodenoscopy (EGD) examination from September 2004 to December 2007. Result: Total of 108 patients underwent EGD examination, comprised of 66 (61%) males and 42 (39%) females, with average age of 45.4 years old (range 16-77 years old). The most frequent indication for EGD was dyspepsia 63%, followed by hematemesis-melena 26% and dysphagia 5.5%. Among patients with dyspepsia, EGD revealed organic abnormalities in 71% patients, with descriptions of erosive gastritis 35%, gastritis 18%, bile reflux 7%, esophagitis 5% and gastric ulcer 3%. Among patients with hematemesis-melena, EGD revealed abnormalities, which were described as erosive gastritis 48%, esophageal varices bleeding 22%, gastric ulcer 18%, caustic injury 4%, and esophagitis 4%. Conclusions: EGD is an important procedure to ascertain the occurence of organic abnormalities in patient with gastrointestinal symptoms and signs e.g. dyspepsia and gastrointestinal bleeding. More than half of patients with dyspepsia showed organic abnormalities. Among patients with hematemesis-melena, erosive gastritis is more common than variceal bleeding. Keywords: esophagogastroduodenoscopy, dyspepsia, upper gastrointestinal bleeding, hematemesis melena
Gastric Mucosa Mucous Layer Thickness in Liver Cirrhosis with Portal Hypertensive Gastropathy Compare to Functional Dyspepsia Loli J Simanjuntak; Chudahman Manan; Marcellus Simandibrata; Vera Yuwono; Rino Alvani Gani; Sabarinah Prasetyo
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: 10.24871/52200448-57

Abstract

Background: This study aimed to investigate gastric mucosa mucous layer thickness in portal hypertensive gastropathy (PHG) compare to normal mucosa in functional dyspepsia and its correlation with several variables such as child class, severity of esophageal varices and gastropathy. Methods: Biopsy specimens were taken from the antrum and corpus from both group of patients with PHG and functional dyspepsia. The specimen was given cryometric for frozen section. Tissue were sliced by sagital section 11 µm, placed in object glass, fixed and stained to evaluate mucous thickness and giemsa stained to observe Helicobacter pylori. Measurement of mucous thickness was done upward muscularis mucosa started from upper epithelial layer from foveale tip until outer mucous layer on 15 points which were marked randomly and calculate the mean value by micrometer (µm). Results: Mean value of antral mucous thickness in PHG was 13.30 ± 6.5 µm, while in the functional dyspepsia it was 25.59 ± 5.66 µm. Statistical analysis for both kinds of mucous thickness was p0.001. Mean corpus mucous thickness in PHG was 10.6 ± 6.81 µm, while mucous thickness in dyspepsia was 32.54 ± 6.51 µm. Statistical analysis revealed p0.001. This result showed significant difference of mucous thickness of antrum and corpus statistically between PHG and dyspepsia as control group. Conclusion: The study had proven the presence of decreased gastric mucosa mucous layer thickness in corpus and antrum in PHG. Thus, therapeutic approach to increase mucous thickness must be considered in patients with PHG. Keywords: Gastric mucosa, PHG, liver cirrhosisemistry
Serial Cases of Combining ESWL and ERCP Procedures in Management Chronic Pancreatitis and Difficult Bile Duct Stones Achmad Fauzi; Nur Rasyid; Ari Fahrial Syam; Murdani Abdullah; Dadang Makmun; Marcellus Simadibrata; Chudahman Manan; Abdul Aziz Rani; Daldiyono Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, NUMBER 3, December 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1032009131-135

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Extracorporeal shock wave lithotripsy (ESWL) has an established role in the management of pancreaticductalcalculiandasfurthertreatmentmodalityforlargeordifficultcomplicatedcommon bile duct(CBD)stones. Combinedwithminimally invasive endoscopic procedure suchasendoscopic retrogradecholangio-pancreatography(ERCP),it has replaced open surgeryas theinitial form of therapy. ESWL has also proved to bean effective therapyin treating intrahepaticstones that are refractory toroutine endoscopic extraction.Inthese serialcaseswe presentthree caseswhichusing combinedESWLandERCP procedurestotreatchronicpancreatitispainandgiantCBDstonethat presentinggoodresultsonfollowupwithoutanycomplication.  Keywords:ESWL, ERCP,chronicpancreatitis, CBDstone
The Causes of Upper Gastrointestinal Bleeding in the National Referral Hospital: Evaluation on Upper Gastrointestinal Tract Endoscopic Result in Five Years Period Ari Fahrial Syam; Murdani Abdullah; Dadang Makmun; Marcellus Simadibrata; Dharmika Djojoningrat; Chudahman Manan; Abdul Aziz Rani; Daldiyono Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 3, December 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/63200571-74

Abstract

Backgrounds: Gastrointestinal bleeding such as hematemesis or melena are common conditions in clinical practice and endoscopic service. The mortality rate due to gastrointestinal bleeding is relatively high. In this study, we evaluate the causes of hematemesis melena for the last 5 years and the factors associated with the bleeding. Methods: The study was done retrospectively. We obtained data from medical record of patients that performed endoscopy of upper gastrointestinal tract in Division of Gastroenterology, Department of Internal medicine, Cipto Mangunkusumo hospital (Jakarta, Indonesia) during the period of 2001 to 2005. Results: Of 4.154 patients who underwent upper gastrointestinal tract endoscopy from 2001 to 2005, we found that 837 patients (20.1%) were due to upper gastrointestinal bleeding. They were 552 male (65.9%) and 285 female patients (34.1%). Mean age of male patients was 52.7 ± 15.82 years, while for female patients was 54.46 ± 17.6 years. Of 837 patients who came due to hematemesis were 150 patients (17.9%), melena were 310 patients (37.8%), both melena and hematemesis were 371 patients (44.3%), 557 cases (66.5 %) due to non varices. Endoscopic results showed that 280 cases (33.4%) were due to esophageal varices. In general, this study had demonstrated that esophageal varices was the most frequent cause of upper gastrointestinal bleeding. We found 229 cases of esophageal varices were coincidence with portal hypertensive gastropathy. While ulcer was found in 225 cases (26.9%) and most of them were gastric ulcer (51.1%). Of gastrointestinal bleeding caused by esophageal varices, most were grade III in 138 cases (49.3%). The incidence of bleeding of bleeding were found more frequently in patients age group of 40 - 60 years (389 cases; 46.5%), 60 years (305 cases; 36.2%), 40 years (242 cases; 16.8%). The causes of bleeding in patients whose age 60 years, most were caused by ulcer (37.4%). In this study, we also found that cancer as the cause of gastrointestinal bleeding in 26 cases (3.1%). Gastrointestinal cancer comprised of gastric cancer in 15 cases (57.7%), duodenal cancer in 7 cases (26.9%), and esophageal cancer in 4 patients (15.4%). Conclusion: The most frequent cause of upper gastrointestinal bleeding was esophageal varices and usually had reached stage III. The non variceal cause of bleeding was gastric cancer. Upper gastrointestinal malignancy was also found to be the etiology of bleeding in this study. Keywords: upper gastrointestinal bleeding, endoscopy
The Diagnostic and Management of Drug Induced Esophagitis Alkindi Bahar; Ari Fahrial Syam; Chudahman Manan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 3, NUMBER 3, December 2002
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/33200286-90

Abstract

There are several factors that involve in drug induced esophagitis such as: drugs, esophagus, patients. The drug can cause direct effect to the esophageal mucosa. The drugs that often cause esphagitis: alendronate, tetracycline and its derivates and anti retroviral agents. Most of these drugs can cause esophageal damage due to corrosive nature of the drug. Esophageal factor that can cause the drug induced esophagitis: rheumatic heart disease, enlargement of the left atrium mass and aortal aneorysma. These conditions will disturb drug passage and prolongs drug contact with esophageal mucosa. The patients factor that influences this problem is the patients position when taking the drug, the patients age, the amount of water taken along with the drug, the time when drug was taken, and the amount of saliva. Endoscopy is a good procedure to evaluate the esophageal mucosa and establishing differential diagnosis through direct inspection, biopsy. In the management of esophagitis, PPIs are currently the most effectiveness agents available for treating esophagitis. Esomeprazole, an optical isomer of omeprazole is the first PPI to show greater efficacy than other PPI is in esophagitis healing.   Keywords: Esophagitis, drug induced, proton pump inhibitor.
Upper Gastrointestinal Malignancy among Dyspepsia Patients in Cipto Mangunkusumo Hospital Jakarta Ali Imron Yusuf; Ari Fahrial Syam; Murdani Abdullah; Dadang Makmun; Marcellus Simadibrata; Chudahman Manan; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, NUMBER 3, December 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/103200992-95

Abstract

Background: Upper gastrointestinal (GI) malignancy was still a health problem in all over the world. The prevalence of the upper GI malignancy vary among Asian countries. Data from Indonesia was scarcely reported. The aim of this study is to determine the frequency of upper GI malignancy among dyspepsia patients who underwent esophagoduodenoscopy (EGD) procedure. Method: This is a retrospectives study from subject with dyspepsia that had underwent upper GI endoscopy at the Department of Internal Medicine Cipto Mangunkusumo hospital from January 2005 to December 2007. All complete data from medical report and histopathology appearance will be recorded. Results: Out of 2,116 subjects underwent endoscopy due to dyspepsia, 110 (5.19%) subjects was diagnosed as cancer. This upper GI malignancy consisted of gastric cancer in 63 (2.97%) cases, esophageal cancer 32 (1.51%) and duodenal cancer 15 (0.71%). The mean ages of the subjects was 53.36 ± 10.97 years, age less than 45 years was 20 (18.20%) subjects, more than 45 years was 90 (81.18%), male 71 (64.50%) subjects, female 39 (35.50%). Most of them had alarm signs 96 (87.30%). Histopathology finding showed adeno-carcinoma in 75 (68.20%) cases, signet ring cell carcinoma in 14 (12.70%), squamous cell carcinoma in 8 (7.30%), others in 13 (11.80%). Out of 59 gastric cancer, 48 (76.20%) cases was located at distal part while the rest 11 (17.50%) cases was located at the proximal gaster, and 4 (6.30%) in diffuse. By the ethnics founded Javanese 37 (33.60%) subjects, Betawinese 22 (20.00%), Sundanese 12 (10.90%) and Batak 13 (11.80%). Conclusions: Upper GI malignancy was found in five percent of subjects with dyspepsia who undergo colonoscopy. The three most frequent malignancies were gastric carcinoma, esophageal carcinoma, and duodenal carcinoma respectively. Most of gastric adenocarcinoma was located at distal stomach. Keywords: upper gastrointestinal malignancy, dyspepsia, endoscopy, alarm sign, histopathology