oesophagus, maag, duodenum (omd).pptx

8/16/2019 OESOPHAGUS, MAAG, DUODENUM (OMD).pptx

1/61

OESOPHAGUS, MAAG,DUODENUM (OMD)

YOHANNA TANIA 42150020

DOSEN PEMBIMBING : Dr. Sudhara!",

S#.$ad


2/61

DE%INISI

• T&'"' #&&r"'aa rad"*+*" a+ura#&-&raa &rd"r" dar" *ra*&*#hau, aa, da du*d&u&ua'a &d"a '*ra /ar"uu+a '&ud"a d"aa" d&au*r*'*#".

• Tu!ua : Uu' &+"ha '&+a"a'&+a"a #ada *ra *&*#hau,aa, da du*d&u


3/61

MEDIA 3ONT$AS

A. 3*ra &d"a #*""

•. 3*ra &d"a a &"+"'" **r a*"".

•. **h : Bar"u u+a (BaS*4)B. 3*ra &d"a &a"

•. 3*ra &d"a a &"+"'" **r a*r&dah.

•. **h : udara

. D*u/+& '*ra

•. Bar"u u+a 6 udara


4/61

37ASI%I3ASI PEME$I3SAANOMD

A. Bar"u 8a++*8

•. P&&r"'aa rad"*+*" *&*au d&a -ara&&+a &d"a '*ra

B. Bar"u &a+

•. P&&r"'aa rad"*+*" +a/u da du*d&ud&a -ara &"u &d"a '*ra

. Bar"u *++*8 hr*uh

•. P&&r"'aa rad"*+*" uu ha+u d&a &"u

&d"a '*ra a &ru#a'a '&+a!ua dar"#&&r"'aa /ar"u &a+ a &&r+u'a 8a'u

/&/&ra#a !a uu' da#a a#a" '& #r*&#&-&raa a'aa


5/61

A$A PEMBE$IAN 3ONT$AS

• Uu' #&&r"'aa *&*au, #a"& d"/&r" u#&" /ar"u'ura +&/"h 29 &d*' a'a. 3*ra /ar"u d"/"ar'a d"da+a u+u &&+ah "u #a"& d""ru'"'a uu'&&+a. P&/uaa rad"*ra d"+a'u'a &&+ah 'ura+&/"h 15 d&"' &&+ah /ar"u d""u.

• S&da'a uu' +a/u da du*d&u &&+ah #a"&d"/&r" u#&" /ar"u 'ura +&/"h 200 +, aau 'ura+&/"h au &+a '&ud"a #a"& d"uruh /&r/ar" d" aa&!a #&&r"'aa da d""a uu' &uar /ada '& '"r"da '& 'aa &/aa' 29 'a+" (/&ru+"u+") d&a

a'ud aar u#&" /ar"u u+a da#a &+a#"" d"d"+a/u da du*d&u &-ara &raa, &&+ah "u &&rad"+a'u'a #&a/"+a rad"*ra. $ad"*ra d"a/"+ &&+ah'ura +&/"h 95 &" #* &d"a '*ra


6/61

P$OYE3SI PEMOT$ETAN

• PA */+"u&

• $"h +a&ra+

•

PA• AP */+"u&


7/61

INDI3ASI

1. D"a"a

2. Su#&' r&u' ar*&*#hau

9. P* *#&ra" &*#hau

4. D"#"a

5. Su#&' &*#+aa &*#hau, a&rda du*d&u

;. H&r"a h"aa+


8/61

3ONT$AINDI3ASI

• Su#&' #&r*ra" "da' /*+&h&ua'a BaSO4 &a#"&ua'a 8a&r *+u/+& '*ra

(ur*ra>, "*#a"r* )

• O/ru'" uu /&ar


9/61

OESOPHAGUS


10/61

1. A'a+a"a E*au• Gaua **r"' #ada **

#*+* &*au, a &"+"'"'ara'&r""' /&ru#a'&aa+a #"-h&r &*au/a8ah uu' /&r&+a'a" da"da' adaa &ra'a

#&r"a+"' #ada &*au• 3&+a"a "" d"&/a/'a

aua &ur*u'u+ara /&ra'"/a '&aa+ar&+a'a" /aa &*a*ar"'(/aa &*a*ar"' !ad"

&#") #ada #r*& &&+a&h"a &&/a/'ad"+aa" (#&+&/ara) /a"a#r*'"a+ &*au. O+&h'ar&a &#"a /aa&*au da +a/u, a'a** /&r'*ra'" a#a


11/61

ETIO7OGI

A. Pr"&r

•. T"da' adaa &+uruh aau &/a"a &+ a+"*"h"/"*r #ada #+&'u M"&&r"'u (Au&r/a-h@)#ada &*au. Ha+ "" &a'"/a'a

'&"da'&"/aa aara &ur* &'"a*r"' da&ur* "h"/"*r"' a &&/a/'a #"-h&r&*au /a8ah "da' da#a /&r&+a'a".

•. S&r" d"ada" d"+aa" &*au da a"

a'aaB. S&'ud&r

•. P&a'" -haa, a+"a", a"+*"d*",ar'*"d*"


12/61

PATO%ISIO7OGI

T&*r" uaa a da#a &!&+a'a#&a'" "", aara +a":

• T&r!ad" a/*ra+"a &ur*&"' #r"&r

a d"&ra" d&a "da' /&ru"a&ur* "h"/"*r"' da &r!ad" d&&&ra"#r*r&" dar" a+"* &+

• T&r!ad" d&>"&" dar" a+"* &+ #+&'u

"&&r"', da#a !ua d"&/a/'a *+&hGar*E*#ha&a+ $&u D"&a& (GE$D),#&a'" haa, da "&'" "ru.


13/61


14/61

MANI%ESTASI

• D"a"a (a'aa #ada da -a"r)• $&ur"a" a'aa

T&r!ad" 'ar&a &rda#a r&&" &!u+ah /&ara'aa #ada &*au a /&rd"+aa". $&ur"a"

"" &r" &r!ad" #ada a+a har" 'ar&a #*""#a"& a &+&a '&"'a "dur, da ha+ ""/&r#*&" &&/a/'a uau #&u*"a a#"ra"

• N&r" dada r&r*&ra+

T&r!ad" 'ar&a adaa &'aa a "" #ada&*au

• H&ar/ur+"'& -h& #a"

Adaa aa +a'a a &r/&u' dar" &r&a""a"a a'aa #ada +u& &*au.


15/61


16/61

%OTO THO$AC

• Adaa d"+aa"&*au

• P&+&/ara &d"a"ua'"/a d"+aa" &*au

• T"da' adaa&+&/u udara a*ra+ #ada +a/u,'ar&a '*ra'"

#"-h&r &*au/a8ah &-&ahudara uu' au' '&da+a +a/u.


17/61

ESO%AGOG$APHY

• E*au /a"ad"a+ a&&ru#a" #aruh/uru (/"rd/&a'a##&ara-&) aau

&'*r "'u (*u&a"+ a##&ara-&)


18/61

ENDOS3OPI

• P&&#"a&*a*ar"'


19/61

2. DIE$TI3E7 ESO%AGUS

• D"&r"'&+ &*au ada+ah #&*!*+a d"d"&*au, /a"' &+uruh /a"a d"d"aau#u haa u'*aa, '& arah +uar +u&&/&u' ru'ur &r" 'a*, a&+"/a'a au aau +&/"h +a#"a d"d"&*au.

• Uua, 'a* &r&/u da#a &r!ad"#ada "a /a"a dar" &*au, a"u#&r/aaa #har*&*#hau(#har*&*#ha&a+ !u-"*), d" /a8ah/"ur-a"* ra'&a, da d" aa d"araa


20/61

37ASI%I3ASI

A. D"&r"'&+ &'&r

• D"&r"'&+ #u+"(d*r*a '&ra) ""&r+&a' d" ar" /a"a

#*&r"*r, a"u d" da+a&""a 3"+++"a, ad"/aa" d" a#" '"r"da 'aa *+&h.'*r"'*r ar"

"&r"*r (.r"*ar"&u)da d" &/&+ah 'auda+*+&h .'r"'*ar"&u.


21/61

B. D"&r"'&+ #ara/r*'"a+

•

D"&r"'&+ ar"' "" aa !ara &r!ad",/"aaa d"&u'a &-ara '&/&u+a.7*'a"a /"aaa d" /a8ah #&r-a/aara'&a , d" d"d" da &*au.

. D"&r"'&+ "&r"'• D"&r"'&+ "#r&"' &ru#a'a aua

&*au a !ara. Ha+ "" /&rhu/uad&a aua *"+"a a &!ad"

#&&/a/ d"&r"'&+ da /&/&ra#a &!a+a a+a".


22/61

ETIO7OGI

• P&&/a/ &r&r" a &daar" &r!ad"a d"&r"'&+&*au ada+ah aua *"+"a dar" &*au.

• P&&/a/ +a" &r" aa+ah ru'ura+ &*au &r" #adad"&r"'&+ &'&r. D"&r"'&+ &'&r &r!ad" 'ar&a '&'a'ua>&r aa &*au &h"aa &'aa d" da+a +u& #ada

aa &&+a &"'a• Pada d"&r"'&+ #ara/r*'"a+ #&&/a/a ada+ah ar"'a dar"

+aur d"d" &*au da #a+" &r" d"&/a/'a *+&h#&&rua '&+&!ar #ara/r*'"a+ 'ar&a u/&r'u+*". 7*'a"a/"aa d" /a8ah #&r-a/aa ra'&a, d" d"d" da &*au.

• S&da'a #ada d"&r"'&+ "&r"' #&&/a/ uaaa a"ua'"/a aua *"+"a. M&uru D&/a, 50 dar" ;5 'aud"&r"'&+ "&r"' &#ua" aua *"+"a d" 'auda+d"&r"'&+, &r&r" /&ru#a #a& da a'a+a"a. S"aa&d&r"a h&r"a h"au da r"'ura


23/61

PATO%ISIO7OGI

• D"&r"'&+ &'&r d"&/a/'a *+&h adaa'&rua'a dar" >&r &*au /a"a aa,&h"a &r!ad" "'**rd"a" aara #&uu#a+*" da a*ar" &ra aa+a **

'r"'*ar"&u /&r&+a'a" &+aa &&+a. Ha+"" &&/a/'a #&"'aa &'aa"ra/*+u &+aa a& &&+a, &h"a &r!ad"h&r"a" #ada ar&a a /&r#*&" +&ah #ada

d"d" ar" #*&r"*r, &ruaa #ada 3"++"a@r"a+& #ada *r*ar" '&"'a &&+a &+a8a&ra'a &uu# >&r &*au /a"a aa.


24/61

• D"&r"'&+ "r&"' "/u+ a'"/a

#&"'aa &'aa &8a'u '*ra'"#*r#u+" &*au &+a8a #r*&#&uu#a >&r &*au /a"a/a8ah.

• D"&r"'&+ #ara/r*'"a+ &/aa"'*&'u&" dar" #&ar"'a &'aa dar"+uar &*au a'"/a #r*& "aa"("a+a a'"/a "aa" '&+&!ar +"&

&d"a"u #ada #a"& u/&r-u+*").


25/61

MANI%ESTASI

A. D"&r"'&+ &'&r

•. D"a"a

•. A#"ra" a a r&'ur& aau /&ru+a

da adaa "r"a" +ar" &&/a/'a/au'

•. A#"ra" *-ura+ &ruaa &r!ad" #ada*ra ua da#a &&/a/'a #&u*"a

/ah'a a/& #aru.•. Suara #arau da#a &r!ad" a'"/a #&&'aa

dar" &ru +ar&a+ r&-ur&.


26/61

B. D"&r"'&+ #ara/r*'"a+

•

Sa'" #ada u/&ra+• D"a"a

. D"&r"'&+ "&r"'

• D"a"a

• S&da8a• N&r" #ada da&rah u/&ra+ da &!a+ar '&

dada /a"a /a8ah, "ar"u, aau #adada&rah #uu d" aara '&dua u+a -a#u+a

• T&r&da' da /au'


27/61

DIE$TI3E7 EN3E$

Pada a/ar d"aa, &r+"ha d"&r"'&+ &/aa" 'a*a "/u+ dar" ar" &ah #ada d"d" ar" d"a+#*&r"*r a /&rd&'aa d&a pharyngoesophageal junction. Ini merupakan identikasi terbaik, saat proses

&&+a, a#a' +a&ra+ a d"&r"'&+a &rda#a #ada


28/61

DIE$TI3E7 EPINE%$I3

• D"&r"'&+ "r&"'a a#a' #ada#&&r"'aa/ar"u

&*a*ra>


29/61

DIE$TI3E7 PA$AB$ON3IA7

• D"&r"'&+ #ara/r*'"a+a a#a' #ada#&&r"'aa&*a*ra> '*ra


30/61

T SAN

• D"&r"'&+ F&'&rda#a d""+a" +&a',

u'ura da /&u''au d"&r"'&+


31/61

9. U73US PEPTI3UM

• Suau +u'a &r/u'a/&r/&u' /u+aaau *a+ #ada

/a"a +a/uaau uu 12 !ar"

• U+'u #ada+a/u u+'u

a&r• U+'u #ada uu 12

!ar" u+'u

du*d&u


32/61

ETIO7OGI

• Helicobacter pylori

• NSAID

•

M"u a+'*h*+ da &r*'*'


33/61

ANATOMI


34/61

PATO%ISIO7OGI

• U+'u #"'u &r!ad" #ada u'*a a&ha"+'a a+'a+", /"aaa #ada aau d"d&'a -uraura "*r, 'ar&a !ar"a """da' da#a &aha '&r!a aa +a/u#&-&raa (H+ da #"). Er*" a &r!ad"/&r'a"a d&a #&"'aa '*&ra"da '&r!a aa #", aau /&r'&aad&a #&urua #&rahaa *ra+ dar"u'*a. Mu'*a a rua' "da' da#a&&'r&" u'u a -u'u# /&r"da'&/aa" /ar"&r &rhada# aa '+*r"da


35/61


36/61

MANI%ESTASI

• N&r"

S&a" u#u+, &ruu', aau &r/a'ar d" "ar"u&ah aau d" #uu

• P"r*" (&r" u+u ha")

S&a" +u'a /a'ar #ada &*au da +a/u, aa"' '& u+u, 'ada'ada d"&ra" &ru'a" aa.Eru'a" ? &da8a &r!ad" /"+a +a/u #a"& '**

• Muah

•

3*"#a"D"& da */a*/aa

• P&rdaraha ar*"&"a+

T"da' &a+a" '&+uha &/&+ua (a& a'u)&a#" &u!u''a &!a+a &&+aha


37/61

U73US GASTE$

• Add""*a+ had*8


38/61

U73US GASTE$•

Adaa a/ara+&&r -ur& u+-&r

• P&/&'a'a ?&d&a d" &'"ar

u+'u da#a&#&r+"ha'a+"#aa+"#aa"&r" da

adaa /aaa/aaa ad"&/u Ha#*7"&.


39/61

U73US DUODENUM

• Adaa a/ara#*h* #"u aau#"&r&& d&*r"


40/61

U73US DUODENUM

• Ga/ara daudada# ? -+*&r+&ad&*r"


41/61

U73US DUODENUM

• +*&r+&ad&*r" *du*d&a+ /u+/(arr*8)


42/61

4. 3A$SINOMA GASTE$

A. Ear+ Gar"- a-&r (EG)

•. I"+ah EG "" &+"#u" &ua 'ar"*aa "da' "a" '&da+a +a#"a

u'u+ar" da a"h &r/aa #adau'*a da u/u'*a. EG da#a/&ru#a #&*!*+a dar" *'u '&-"+ da'ada &-ara d"ad"a &+ua,

&h"a &&a'a '&u'"adar" a/ua /&/&ra#a *'u(u+"-&r").


43/61

37ASI%I3ASI EG• 3+a">'a" 'ar"*a +a/u &uru a#a Gar*&&r*+*"-a+

Ed*-*# S*-"& :

1. T"#& I (#r*rud&d #&) : u*r aa a &"a" haa &r/aa#ada u'*a da u/u'*a a /&r/&u' #*+"#*"d. B&u'a "r&u+&r,#&ru'aa "da' raa, #&rdaraha d&a aau a#a u+&ra".

2. T"#& II (u#&r>-"a+ #&) : Da#a d"/a" aa 9 u/"#& :

a. Elevated type :

Ta#a' &d"'" &+&a" u'*a +a/u, ha#"r &r" "#& I, &rda#a&d"'" &+&a" &ra da +&/"h &+ua da &+&/ar.

/. Flat type:

T"da' &r+"ha &+&a" aau dr&" #ada u'*a da haa &r+"ha#&ru/aha #ada 8ara u'*a.

-. Depressed type:

D"da#a'a #&ru'aa a "r&u+&r da #""r a "da' raa ("r&u+&r)h"#&r&"? #&daraha

9. T"#& III (&-aa&d #&) : &&ru#a" B*ra II (u*r aa +a!u) da

&r" d"&ra" '*/"a" &r" II- 6 III aau III 6 II- da IIa 6 II-.


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B. Ada-&d Gar"- a-&r (AGr)

• Pada "#& +a!u, &+&+ 'a'&r udah&r!ad" #&r+uaa #ada +a#"au'*a, u/u'*a, u'u+ar",

'ada'ada a#a" +a#"a#r*#r"a da &r*a. Bah'a &r"&r!ad" ">+ra" aau &aa& '&

'&+&!ar +"& aau *ra +a"a.


45/61

37ASI%I3ASI

• M&uru '+a">'a" B*ra da#a d"/a" aa:

1. B*ra I: B&u'a /&ru#a #*+"#*"d 'ar"*a a&r" !ua d"&/u &/aa" ua" da u'*a d" &'"aru*r ar*> da "r&u+&r

2. B*ra II: M&ru#a'a * ">+ra" -ar-"*a*u u+-&rd&a " u+'u &ra u'*a &'"ara &*!*+ dad"&ra" *du+ar. Daar u+'u &r+"ha &'r*" d&a 8ara'&-*'+aa, '&a/ua da &rah '&h"aa. Mu'*a &'"aru+'u a#a' aa h"#&r&"

9. B*ra III: /&ru#a ">+ra" -ar-"*a*u u+-&r,u+'ua &#ua" d"d" da &r+"ha adaa ">+ra"#r*r&" da d"u

4. B*ra I: /&ru#a /&u' d"u& ">+ra" #&, "da'&r+"ha /aa &a #ada d"d" da ">+ra" d"u #ada&+uruh u'*a.


46/61

PATO7OGI

• 3&/aa'a 'a'&r a&r ada+ah ad&*'ar"*a (0 J K), a +a"+"*a, +&"*"*ar'*a, ad&*ah*a da +a"+a". 3&/aa'a+*'a" u*r #ada da&rah ar*#"+*r"', 'uraura "*r +&/"h &r"dar"#ada 'uraura a*r. 3ar"*a a&r /&raa+ /&raa+ dar"#&ru/aha "&+ #ada &/ra& u'*a a&r, a /&r'&/a#ada /a"a /a8ah a&r, &da'a #ada ar*> a&r d"da#a'a

/a"a aa a&r da &-ara u+"&&r.• 3ar"*a a&r &r+"ha /&/&ra#a /&u' :

1. S&r&#aa /&raa+ dar" #r*#"a a /&r/&u' ua" dau/uh '& +u& &/aa" aa.

2. S&r&#aa /&r/&u' u*r a /&ru+&ra"

9. Maa a u/uh &+a+u" d"d" &"a" +a#"a **.

4. P&&/araa &+a+u" d"d" a d"-&ar" #&&/ara #ada#&ru'aa (=K)

5. B&r/&u' +"""#+a"'a (10 J 15K)

;. S&r"aa 'ar"*a /&r/aa" /&u' d" aa.


47/61

MANI%ESTASI

• B&ra /ada &uru

• N&r" "ar"u

• Muah

• '&+uha #&-&raa

• A*r&'"a• D"a"a

• Nau&a

• 3&+&aha

•

S&da8a• H&a&&"

• $&ur"a"

• 7&'a '&a


48/61

37ASI%I3ASI TNM 3A$SINOMA GASTE$

Tu*r Pr"&r

• T" : ar-"*a ""u

• T1 : Ia" '& +a"a #r*#r"a aau u/u'*a

• T2 : Ia" '& u'u+ar" #r*#r"a

• T9 : P&&ra" '& &r*a

• T4 : Ia" '& *ra &'"arM&aa" 3&+&!ar 7"& $&"*a+

• N0 : N*&

• N1 : M&aa" '& '&+&!ar #&r"ar"' 9 - dar" u*r #r"&r

• N2 : M&aa" '& '&+&!ar +"& #&r"ar"' +&/"h dar" 9 - dar" #""ru*r #r"&r (a!a +a/u '"r", -** ha"-, +"#a aauar&r" -&+"a-)

M&aa" auh

• M0 : N*&

• M1 : M&aa" !auh


49/61

STAGING

0 Tis N0 M0

1 T1 T2

N01N0

M0M0

2 T1

T2 T9

N2

N1N0

M0

M0M0

9 T2 T9 T4

N2N12N01

M0M0M0

4 T4 T14

N2N12

M0M1


50/61

EG

• Adaa a/ara>++" d&&-


51/61

AGr

• Adaa a/arah"+aad"&"/"+"a da'**ur a a/*ra+

dar" a&rd"'ar&a'aad&*-ar-"*a">+ra".

•

Adaa a/araL+&ah&r /*+& a#a' &r" #aruh#ada &*au d"a+


52/61

T SAN

• AGr d&a&aa& '&har da adaa

a-"&


53/61

5. O7U7US GASTE$

• 3&+a"a '*&"a+ d&>"&" >'a"dar" a&r '& !ar"a &'"ara&h"a a&r da#a &r#u"r.


54/61

ETIO7OGI

A. 3*&"a+

B. Id"*#a"'

A/*ra+"a '&+&ura dar"+"a& ar*#+&"',ar*du*d&a+, ar*r&"', daar*ha"'


55/61

37ASI%I3ASIA. Ora*a'"a+

• Ga&r /&r*a" &&+"+"" a'" a &hu/u'aar*&*a&a+ !u-"* da /a"a aru #"+*ru /&r*a"'& arah a /&r/&da d&a r*a" /a"a udu. *+u+ua&r "#& *ra*a'"a+ /&rhu/ua d&a d&&'d"araa"'a. 3*#+"'a" /&ru#a "'ar&ra" da rau+a"

+&/"h &r" d"!u#a" #ada "#& "".

B. M&&&r"'*a'"a+

• Pada "#& &&&r"'*a'"a+, aru #"+*ru /&r*a" '& araha&r"*r da u#&r"*r &h"a #&ru'aa #*&r"*r a&r/&rada d" a&r"*r.

• *+u+u a&r "#& "" "da' /&rhu/ua d&a d&&' d"a raa"'a da !ara &"/u+'a '*#+"'a" rau+a",&h"a +&/"h &r" /&r"a 'r*".

. 3*/"a"

• 3*/"a" "#& '*/"a" aara *ra*a'"a+ da &&&r"'*a'"a+ (!ara d"&u'a).


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O$GANOA3SIA7

• Ga&r /&r*a" &&+"+"" a'" a &huhu'aar*&*a&a+ !u-"*da /a"a aru #"+*ru/&r*a" '& arah a/&r/&da d&a r*a"/a"a udu.


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MESENTE$OA3SIA7

• Aru #"+*ru /&r*a" '& arah

a&r"*r dau#&r"*r &h"a#&ru'aa

#*&r"*r a&r/&rada d" a&r"*r.


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DA%TA$ PUSTA3A

• Sud**, Aru . Bu'u A!ar I+u P&a'"Da+a "+"d I Ed"" I. a'ara: PuaP&&r/"a I+u P&a'" Da+a, %3 UI.

200


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TE$IMA3ASIH

oesophagus, maag, duodenum (omd).pptx

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