tugas kasus radiologi nefrolithiasis

7/23/2019 Tugas Kasus Radiologi Nefrolithiasis

http://slidepdf.com/reader/full/tugas-kasus-radiologi-nefrolithiasis 1/77

SEORANG PASIEN DENGANNEFROLITIASIS DAN HIDRONEFROSIS

OLEH : Jessica Philbertha4061300

PEMBIMBING :"r# Lia Sas"esi $a%&iri' S(# Ra"NIP ) 1*+31,0 ,00604 , 00,



Latar -ela.a%&

• Il/ .e".tera% ra"il&i se/a.i% la/ase/a.i% ber.e/ba%&#

• Ter"iri atas ba&ia% ra"i "ia&%sti. "a%

ra"i tera(i#• -ebera(a c%th (e/eri.saa% ra"il&i

a"alah 2t ra5' SG' 7T sca%' $RI' "a%/asih ba%5a. la&i#

• Pe%5a.it hi"r%e2rsis "a% %e2rlitiasis"a(at "i"ete.si /e%&&%a.a%(e/eri.saa% ra"il&i#



T8a%

• $e%&etahi "a% /e/aha/i a%at/i tra.tsri%aris#

• $e%&etahi "a% /e/aha/i 9sil&i tra.ts

ri%aris#• $e%&etahi "a% /e/aha/i hi"r%e2rsis

"a% %e2rlitiasis :"e9%isi' e(i"e/il&i'etil&i' 2a.tr resi.' ta%"a "a% &e8ala'

(at9sil&i' "ia&%sis' (e/eri.saa%(e%%8a%&' tatala.sa%a' (r&%sis'./(li.asi' (e%ce&aha%' "ia&%sis ba%"i%&;#



$a%2aat

• De%&a% (e%lisa% la(ra% .ass i%i"ihara(.a% "a(at "i8a"i.a% seba&ai/e"ia bela8ar ba&i /ahasis<a .li%i.

sehi%&&a "a(at /e%"ia&%sisterta/a secara ra"il&is "a%/e%&ella (asie% "e%&a%

(er/asalaha% se(erti (a"a (asie% i%isecara ./(rehe%si2#



A%at/i Tra.ts ri%aris

• Siste/ tra.ts ri%aris /e/e&a%& (era%a%"ala/ (e/be%t.a%' (e%a/(%&a%se/e%tara' "a% (e%&elara% ri%#

•Or&a%r&a%%5a ter"iri "ari ) – Re% :&i%8al;' 5a%& /e/be%t. ri%#

– reter' 5a%& /e%&alir.a% ri% "ari &i%8al .e.a%"%& .e/ih#

– =esica ri%aria' 5a%& /e%a/(%& air .e/ih:ri%; %t. se/e%tara#

– retra' salra% 5a%& /e%&lar.a% ri%#



Gi%8al



reter



=esica ri%aria



retra



Fisil&i Tra.ts ri%aris

F%&si s(esi9. "ari &i%8al a"alah )

• $e/(ertaha%.a% .esei/ba%&a% H,O "ala/

tbh#

•

$e%&atr 8/lah "a% .%se%trasi seba&ia%besar i% 7ES ter/as. Na>' ? >' 7l' H7O3' 7a ,>'

$&,>' SO4,' PO4

3' "a% H>#

• $e/elihara @l/e (las/a 5a%& sesai'

sehi%&&a sa%&at ber(era% "ala/ (e%&atra% 8a%&.a (a%8a%& te.a%a% "arah arteri# F%&si i%i"ila.sa%a.a% /elali (era% &i%8al seba&ai(e%&atr .esei/ba%&a% &ara/ "a% H,O#



• $e/ba%t /e/elihara .esei/ba%&a% asa/basa tbh#

• $e/elihara s/laritas#

• $e%&e.s.resi.a% (r". sisa "ari /etablis/ese(erti res' asa/ rat' "a% .reati%i%#

•

$e%&e.s.resi.a% ba%5a. se%5a<a asi%&'/isal%5a bat' (estisi"a' "ll#

• $e%se.resi.a% eritr(ieti% %t. /era%&sa%&(e/be%t.a% sel "arah /erah#

•

$e%se.resi.a% re%i%' sat hr/% e%i/ati.5a%& /e/ic rea.si bera%tai 5a%& (e%ti%&"ala/ (rses .%ser@asi &ara/ leh &i%8al#

• $e%&bah @ita/i% D /e%8a"i be%t. a.ti2%5a#



Taha( Pe/be%t.a% ri%e

• Filtrasi

• Reabsr(si

•

Se.resi



Ne2rlitiasis

• -at "i "ala/ salra% .e/ih a"alah/assa .eras se(erti bat 5a%& terbe%t."i se(a%8a%& salra% .e/ih "a% bisa

/e%5ebab.a% %5eri' (er"araha%'(e%5/bata% alira% ri%' ata i%2e.si#

• $e%rt l.asi%5a )

– %e2rlitiasis :&i%8al;'

– reterlitiasis :reter;'

– @esi.litiasis :.a%"%& .e/ih;'

– retrlitiasis :retra;#



Etil&i

• Ga%&&a% alira% ri%

• Ga%&&a% /etabli.

•

I%2e.si salra% .e/ih• Dehi"rasi

• I"i(ati.



Fa.tr Resi.

Intrinsik

• Here"iter

• /r

• Je%is .ela/i%

Ekstrinsik

•

Ge&ra9s• I.li/

• As(a% air

• Diet

•

Pe.er8aa%



Pat9sil&i

• ?ristal r&a%i. "a% a%r&a%i. (resi(itasi %.leasi /e%e/(el (a"a e(itel salra%.e/ih (e%&e%"a(a% baha%baha% lai%

c.( %t. /e%5ebab.a% bstr.si#• ?%"isi /etastable "i(e%&arhi leh sh'

(H larta%' a"a%5a .li" "i "ala/ ri%'.%se%trasi slt "i "ala/ ri%' la8 alira%

ri% "i "ala/ salra% .e/ih' ata a"a%5a.r(s alie%/ "i "ala/ salra% .e/ih 5a%&berti%"a. seba&ai i%ti bat#



• ?alsi/ biasa%5a beri.ata% "e%&a% .salat/a(% 2s2at#

• -at asa/ rat terbe%t. (a"a ssa%aasa/#

• -at /a&%esi/ a/%i/ 2s2at terbe%t.

(a"a sasa%a basa#• I% /a&%esi/ "a% sitrat a.a% beri.ata%

"e%&a% .salah sehi%&&a /e%&ha/bat(e/be%t.a% bat .alsi/ .salat#

• Pe%&ha/bat lai% ) &li.sa/i%&li.a%' (rtei% Ta// Hrs2all ata r/.i"' %e2r.alsi%'"a% ste(%ti%#



Je%is -at

• -at .alsi/

• -at str@it

•

-at asa/ rat• Lai%%5a



-at Gi%8al "a% -at reter

• ?elha% ter&a%t%& (a"a (sisi "a%leta. bat' besar bat' "a% (e%5lit#

• ?elha% 5a%& seri%& ) – N5eri (a"a (i%&&a%& :.li.' %% .li.;

– He/atria

– De/a/

• PF ) %5eri .et. 7=A :>;



Pe/eri.saa% Labratri/

• Se"i/e% ri%e ) le.sria' he/atria' "a%"i8/(ai .ristal.ristal (e/be%t. bat#

• ?ltr ) /%&.i% a"a (ert/bha% ./a%

(e/ecah rea#• Pe/eri.saa% 2aal &i%8al ber2%&si %t.

/e/(ersia(.a% (asie% 5a%& a.a%/e%8ala%i (e/eri.saa% I=#

• Perl 8&a "i(eri.sa .a"ar ele.trlit 5a%&"i"&a seba&ai 2a.tr (e%5ebab ti/bl%5abat salra% .e/ih#



Pe/eri.saa% Ra"il&is

• FPA – -ert8a% %t. /elihat .e/%&.i%a% a"a%5a bat

ra"i(a. "i salra% .e/ih#

• I=P – $e%ilai a%at/i "a% 2%&si &i%8al#

– Da(at /e%"ete.si bat (a. "a% se/i(a.#

– Ji.a ti"a. bisa RPG#

• SG – Da(at %t. (asie% aler&i' ha/il' (e%r%a% 2%&si

&i%8al#

– Da(at /e%ilai a"a%5a bat "i &i%8al ata blibli'hi"r%e2rsis' (iel%e2rsis' ata (e%&erta% &i%8al#



Tatala.sa%a

• I%"i.asi %t. /ela..a% ti%"a.a% (a"abat salra% .e/ih a"alah 8i.a bat telah/e%i/bl.a% bstr.si' i%2e.si' ata hars

"ia/bil .are%a sesat i%"i.asi ssial#• Piliha% tatala.sa%a )

– $e"i.a/e%tsa

– ESBL

– E%"rl&i

– La(ars.(i

– -e"ah terb.a



Pe%ce&aha%

• $e%&hi%"ari "ehi"rasi "e%&a% /i%/ c.( "a%"isaha.a% (r".si ri%e seba%5a. ,3 liter (erhari#

• Diet %t. /e%&ra%&i .a"ar at ./(ete/

(e/be%t. bat :"iet re%"ah (ri%' (rtei%' "a%&ara/;#

• A.ti@itas haria% 5a%& c.(#

• Hi%"ari @ita/i% 7 "a% .alsi/ berlebih' terta/a

5a%& berasal "ari s(le/e%#• ?%s/si bat se(erti thiai"es' (tasi/ sitrat'

/a&%esi/ sitrat' "a% all(ri%l ter&a%t%& "ari 8e%is bat%5a#



Hi"r%e2rsis

• Hi"r%e2rsis a"alah "iste%si "ari.aliC re%al "a% (el@is re%al 5a%&"isebab.a% leh bstr.si alira%

ri%e "i "istal "ari (el@is re%al#• Hi"r%e2rsis "a(at /er(a.a%

.e8a"ia% a.t /a(% .r%i.'

%ilateral /a(% bilateral#• ?/(li.asi ) &a&al &i%8al' i%2e.si'

.al..s' se(sis' ate/ia'

hi(erte%si#



Etil&i

• reter ) stri.tr =J' bstr.si =J'=R' %er&e%ic bla""er' "ll#

• ?a%"%& .e/ih ) .arsi%/a .a%"%&.e/ih' =R' "ll#

• retra ) stri.tr retra' -PH' .a%.er(rstat' "ll#



Pat9sil&i

• Ga%&&a% a%at/i ata 9sil&i "aritra.ts ri%aris 5a%& "a(at/e%5ebab.a% &a%&&a% (asase

ri%e "ari &i%8al#• Diba&i , ) a.t "a% .r%i.#



Ta%"a "a% Ge8ala

• N5eri

• Disria hi%&&a a%ria

• De/a/

• He/atria• Ji.a .e"a &i%8al ter.e%a' /a.a a.a% /%cl

ta%"a "a% &e8ala &a&al &i%8al se(ertihi(erte%si' &a&al 8a%t%& .%&esi2'

(eri.ar"itis' (rritis' a%re.sia' /al/%tah' "a% lai% seba&ai%5a;#

• PF ) %5eri .et. 7=A :>;' ballte/e%t :>;#



Dera8at Hi"r%e2rsis

• Dera8at .e(araha% "ari hi"r%e2rsis"ilihat "e%&a% SG ) – $il" ) se(arasi .ecil (a"a (la .ali.s' ech

%r/al' .etebala% (are%.i/ %r/al# – $"erate ) ball%i%& (a"a .ali.s /a5r

"a% /i%r' hi(e.i.' .etebala% (are%.i/%r/al ata se"i.it /e%i(is#

– Se@ere ) "ilatasi /asi2 "ari (el@is re%al "a%.ali.s "e%&a% (e%i(isa% .rte.s &i%8al'hi(e.i.#



A"a 4 "era8at hi"r%e2rsis /e%rt I=P )1# Dilatasi (el@is re%alis ta%(a "ilatasi .ali.s# ?ali.s

berbe%t. bl%ti%& :t/(l;#

,# Dilatasi (el@is re%alis "a% .ali.s /a5r# ?ali.s

berbe%t. atte%i%& :"atar;#3# Dilatasi (el@is re%alis' .ali.s /a5r "a% .ali.s

/i%r' ta%(a a"a%5a (e%i(isa% .rte.s# ?ali.sberbe%t. clbbi%& :/e%%8l;#

4# Dilatasi (el@is re%alis' .ali.s /a5r "a% /i%r'serta a"a%5a (e%i(isa% .rte.s# ?ali.sberbe%t. ball%i%& :/e%&e/b%&;#



Pe/eri.saa% Labratri/

• ri%alisis ) i%2e.si#

• He/atria /e%&i%"i.asi.a% .ebera"aa%bat ata t/r#

• 7-7 "ite/.a% le.sitsis ) i%2e.sia.t#

• ?i/ia "arah ) -N "a% .a"ar .reati%i%

(a"a hi"r%e2rsis bilateral#• Ji.a ter8a"i hi(er.ale/ia /e%%8..a%

sat .%"isi 5a%& /e%&a%ca/ %5a<a#



Pe/eri.saa% Ra"il&is

• SG

– Pe/eri.saa% %t. /e%&etahi bstr.si "aritra.ts ri%aris#

– Ti"a. a"a resi. aler&i "a% t.si.#

• 7T sca%

– Dila..a% 8i.a hasil SG ei@cal' &i%8al ti"a."a(at "[email protected]% "e%&a% bai.' ata(% 8i.a

(e%5ebab bstr.si ti"a. "a(at"ii"e%ti9.asi.a%#

– A"e.at %t. /e%"ia&%sis lebih "ari *0.ass#



• I=P – $e/ili.i .elebiha% 8i.a "iba%"i%&.a% "e%&a% SG#

– False (siti2 sa%&at re%"ah "a% "a(at /e%&i"e%ti9.asileta. bstr.si' 8&a "a(at /e/ba%t /e%"ete.si.%"isi ter.ait se(erti %e.rsis (a(ila ata

(e%/(la% .ali.s re%al .are%a i%2e.si# – Na/%' I=P /e/erl.a% .%tras :e2e. sa/(i%&

aler&i;#

– I=P "a(at /e/ba%t /e/be"a.a% .al.ls sta&hr%"e%&a% .ista /lti(el re%al ata (ara(el@i. 5a%&

seri%&.ali ti"a. ter"e.et.si "e%&a% /e%&&%a.a% SGata 7T sca%#



Tatala.sa%a

• T8a% ) /e%&i"e%ti9.asi "a%/e/(erbai.i (e%5ebab bstr.si'/e%a%&a%i i%2e.si' "a% /e/(ertaha%.a%

serta /eli%"%&i 2%&si &i%8al#• -ebera(a (iliha% tatala.sa%a )

– Ne2rst/i

– A%ti/i.rba

– -e"ah

– Ne2re.t/i



GAMBARAN RADIOLOGI PADA

NEFROLITIASIS DAN HIDRONEFROSIS



Ne2rlitiasis :FPA;

• ?elebiha% /e%&&%a.a% -NO )

– Relati2 /rah

– 7e(at

–Da(at /e%e/t.a% (sisi bat

– $e/beri.a% &a/bara% ab"/e% "a% (el@issecara le%&.a(

• ?e.ra%&a% /e%&&%a.a% -NO )

– Ti"a. "a(at /e%"ete.si bat ra"ilse%

– Ti"a. "a(at /e/be"a.a% bat ra"i(a.ata .alsi9.asi



Ne2rlitiasis :FPA;

• Persia(a% %t. -NO ) – Ti"a. /er..

– $i%/ la.sa% saat /ala/ sebel/

(e/eri.saa% – Pasa /i%i/al 8a/ sebel/ (e/eri.saa%

– $a.a% re%"ah serat 3 hari sebel/(e/eri.saa%

– Telah -A- "i r/ah (a"a (a&i sebel/(e/eri.saa%



Ne2rlitiasis :FPA;

Normal Batu



Ne2rltiasis :SG;

• ?elebiha% /e%&&%a.a% SG ) – Ti"a. a"a .%trai%"i.asi

– Da(at /elihat se/a 8e%is bat beserta .ra%%5a

– Relati2 /rah

– Da(at "i&%a.a% leh (asie% ha/il ata aler&i .%tras – Da(at /e%e%t.a% hi"r%e2rsis seba&ai a.ibat "ari

bstr.si bat

• ?e.ra%&a% /e%&&%a.a% SG ) – O(eratr "e(e%"a%t

– Ti"a. "a(at /e%ilai bat "i reter

– Ti"a. "a(at /e/be"a.a% bat ra"i(a. ata ra"ilse%

– Slit /e%%8..a% bat 5a%& .ra%%5a sa%&at .ecil



Ne2rltiasis :SG;

• Persia(a% ) – Pasa /i%i/al 6 8a/

– Sebel/ (e/eri.saa% /i%/ air (tih

5a%& ba%5a. "a% /e%aha% .e%ci%& a&ar@esica ri%aria "a(at "ilihat (a"a SGab"/e%



Ne2rltiasis :SG;

Normal Batu



Ne2rlitiasis :I=P;

• I=P /er(a.a% (e/eri.saa%ra"i&ra9 (a"a siste/ ri%aria"e%&a% /e%5%ti..a% at .%tras

/elali (e/blh "arah @e%a#• T8a% (e/eri.saa% i%i a"alah %t.

/e%"a(at.a% &a/bara% ra"il&is

"ari leta. a%at/i "a% 9sil&i serta/e%"ete.si .elai%a% (atl&is "ari&i%8al' reter' "a% .a%"%& .e/ih#



Ne2rlitiasis :I=P;

Indikasi

• -at salra% .e/ih

• ?ecri&aa%

t/r.e&a%asa%tra.ts ri%aris

• I%2e.si tra.tsri%aris berla%&

setelah tera(ia%tibiti. 5a%&a"e.at

• Hi"r%e2rsis

Kontraindikasi

• Aler&i terha"a( /e"ia.%tras

• Pasie% "e%&a% ri<a5at ata"ala/ sera%&a% 8a%t%&

• $lti(le /iel/a

• Ne%ats

• D$ ti"a. ter.%trl

•

Pasie% 5a%& se"a%& "ala/.ea"aa% .li.

• Hasil re/ "a% .reati%i%ti"a. %r/al



Ne2rlitiasis :I=P;

• Persia(a% ) – ?a"ar re/ .reati%i% "arah hars %r/al

– $ala/ sebel/%5a "iberi la.sa% :1, 8a/ sebel/(e/eri.saa%;

–

$a.a% re%"ah serat "a% te.str l%a. sela/a 3 harisebel/ (e/eri.saa%

– Ti"a. /i%/ se8a. 8a/ ,,#00 %t. /e%"a(at.a% .%"isi"ehi"rasi ri%&a%

– $e%&ra%&i r..

– $e/asti.a% ti"a. aler&i .%tras "e%&a% /ela..a% s.i%test

– Sebel/ (e/eri.saa% (asie% "isrh ber.e/ih %t./e/asti.a% (e%&s%&a% tra.ts ri%aris



Ne2rlitiasis :I=P;

m!nit "N!#ro$ram% & m!nit "Pi!lo$ram%NORMAL



Ne2rlitiasis :I=P;

'( m!nit "Sisto$ram% Post )oidin$

NORMAL



Ne2rlitiasis :I=P;

Normal Batu



Ne2rlitiasis :7T Sca%;

• Pa"a .ass bat &i%8al' 7T sca% %%.%tras /e/ili.i se%siti@itas *100 "a%s(esi9sitas *4*6#

•

?elebiha%%5a a"alah (ali%& "e9%iti2 "a%s(esi9.' 8&a /e/beri.a% i%2r/asite%ta%& .%"isi selai% siste/&e%itri%aris#

• ?er&ia%%5a a"alah /ahal "a% .ra%&ter8a%&.a' ti"a. /e%&.r 2%&si &i%8al'"a% a"a%5a ra"iasi#




• Persia(a%%5a a"alah /i%/la.sa%sia saat /ala/ sebel/(e/eri.saa%' (asa /i%i/al 8a/'

/a.a% re%"ah serat 3 hari sebel/(e/eri.saa%' telah -A- "i r/ah(a&i sebel/ (e/eri.saa%#




Normal N!#rolitiasis



Hi"r%e2rsis :SG;

Mild Mod!rat!



Hi"r%e2rsis :SG;

S!*!r!



Hi"r%e2rsis :I=P;



Hi"r%e2rsis :7T Sca%;

• Sta"i/ "i%i ) &a/bara%.ali..ali. 5a%&/e%"atar :fattening;#Perbaha% i%i re@ersibel#

• Sta"i/ la%8t ) .ali..ali. 5a%& berbe%t.t%&.at :clubbing;#

• Sta"i/ 5a%& lebih

(arah la&i ter8a"i"estr.si (are%.i/ "a%(e/besara% salra%.e/ih#



La+oran Kasus



A%a/%esaId!ntitas

• Na/a ) N5# D# S

• Je%is ?ela/i% ) Pere/(a%

• sia ) 6 tah%

•

Ta%&&al Lahir ) 6 $aret 1*4*• Ala/at ) Pca%& A"i I= N# 4

• Pe.er8aa% ) Pe%si%a% PNS :GrSD;

•

Pe%"i"i.a% ) D,• A&a/a ) Isla/

• Stats Per%i.aha% ) $e%i.ah

• N# Re&# 7$ ) ,4+

• Ta%&&al Peri.sa ) 6 $ei ,014



K!lu,an -tama: N5eri (i%&&a%& sebelah .a%a%

Ri.a/at P!n/akit S!karan$ :

Pasie% "ata%& .e (li be"ah RSD ?ta Se/ara%& (a"a hariSe%i%' $ei ,014 "e%&a% .elha% %5eri (i%&&a%& sebelah.a%a% se8a. 1 bla% 5a%& lal# N5eri ti"a. "irasa.a% ters/e%ers' "i(erberat 8i.a ber"iri terlal la/a' "a% %5eribiasa%5a hila%& (a"a saat berbari%&# Ri<a5at ba%& air

.ecil la%car "a% ti"a. a"a (e%r%a% 2re.e%si# Na/%/e%rt (asie%' bebera(a bla% lal ia se/(at /ela..a%(e/eri.saa% ri%e "i labratri/ "a% hasil%5a ri%eber<ar%a .erh# Ti"a. a"a &a%&&a% (a"a ri<a5at ba%&air besar# ?elha% ta/baha% lai% se(erti "e/a/' /al'

/%tah' "isria' "a% sa.it (ert "isa%&.al# Ter"a(at ri<a5at.ebiasaa% 8ara%& /i%/ "a% s.a /e%&.%s/si&re%&a%# Setelah berbat "i (li be"ah' (asie% "ia%8r.a%%t. /ela..a% /e/eri.saa% SG ab"/e% "a%"iberi.a% bat Na "i.l2e%a. 0 /& "a% /e(rale %t./e%&ra%&i rasa %5eri (a"a (i%&&a%& .a%a% (asie%#

Ri.a/at P!n/akit Da,ulu :



/ /

• Pa"a tah% 1**' (asie% (er%ah /e%&ala/i .elha%5a%& sa/a ber(a %5eri (i%&&a%& sebelah .a%a%#Pasie% .e/"ia% /e%8ala%i (e/eri.saa% SG "a%"i"ia&%sis /e%&ala/i %e2rlithiasis# Setelah

/e%&.%s/si bat /i%/ :(asie% ti"a./e%&etahi %a/a bat%5a;' &e8ala %5eri (i%&&a%&sebelah .a%a% hila%&#

• Pasie% /e/ili.i ri<a5at sa.it /aa& 5a%& ter.a"a%&.a/bh :biasa%5a "ibati "e%&a% /e(rale;#

• Pa"a se.itar bla% $aret ,014' (asie% /e%"erita"e/a/ ti2i" "a% se.ara%& telah se/bh#

•

Hi(er.lesterle/ia "a% hi(ertri&liseri"e/ia 5a%&hi%&&a .i%i "ibati "e%&a% si/@astati% 10 /& sat.ali sehari /ala/ hari#

• Ri<a5at (e%5a.it hi(erte%si' str.e' D$ "a% aler&i"isa%&.al#

Ri.a/at P!n/akit K!luar$a :



Ri.a/at P!n/akit K!luar$a :

• Ti"a. a"a .elar&a 5a%& (er%ah /e%&ala/i.elha% ser(a /a(% /e%"erita

%e2rlitiasis "a% hi"r%e2rsis# Ti"a. a"ari<a5at hi(erte%si' str.e' /a(% D$ (a"a.elar&a#

Ri.a/at Sosial Ekonomi :

• Pasie% telah /e%i.ah "a% /e/ili.i , ra%&a%a. "a% , ra%& cc# Saat i%i (asie% ti%&&albersa/a sa/i%5a# Pasie% /er(a.a%(e%si%a% PNS 5a%& "l /er(a.a% &rSD# Sa/i (asie% /er(a.a% &r S$A#Pasie% berbat "e%&a% /e%&&%a.a% -PJS#



Pe/eri.saa% Fisi.

K!adaan -mum :

• ?esa"ara% ./(s /e%tis' G7S E4 = $6 :1;'ta/(a. sa.it ri%&a%#

• Ta%"a =ital )

– Te.a%a% "arah ) 1,00 //H& – Na"i ) 6 C/e%it' re&ler' isi c.(

– La8 %a2as) 16 C/e%it' re&ler

– Sh) 36' 07

•

Data a%tr(/etri ) – -erat ba"a% ) 0 .&

– Ti%&&i ba"a% ) 1 c/

– I$T ) ,0' :normoweight ;



• Pe/eri.saa% siste/atis se/a"ala/ batas %r/al .ecali ) – -allte/e%t teraba :>;#

– N5eri .et. .st@ertebra .a%a% :>;#



Labratri/

• Saat i%i bel/ "ila..a%(e/eri.saa% labratri/ la&ise(erti re/ .reati%i%# Na/%'

/e%rt (asie% bebera(a bla% 5a%&lal (asie% se/(at /ela..a%(e/eri.saa% labratri/ "e%&a%

hasil .lesterl "a% tri&liseri"a "iatas batas %ilai %r/al "a%(e/eri.saa% ri%e /e%%8..a%hasil 5a%& .erh#



Pe/eri.saa% Ra"il&i

Int!r+r!tasi ,asil -SG a0dom!n :

• HEPAR .ra% "a% be%t. %r/al' (are%.i/ h/&e%'e.&e%isitas %r/al' te(i rata' s"t ta8a/' ta. ta/(a. %"l' =#Prta "a% =# He(ati.a ta. /elebar#

• )ESIKA FELLEA ta. /e/besar' "i%"i%& ta. /e%ebal' ta.ta/(a. bat#

• LIEN .ra% %r/al' (are%.i/ h/&e%' =# Lie%alis ta./elebar' ta. ta/(a. %"l#

• PANKREAS .ra% %r/al' (are%.i/ h/&e%' ".ts

(a%.reati.s ta. /elebar#• GIN1AL KANAN .ra% "a% be%t. %r/al' (are%.i/ /lai

ti(is' P7S /elebar' ta/(a. bat /lti(le .ra% terbesar 1'3+c/' ta. ta/(a. /assa#



• GIN1AL KIRI .ra% "a% be%t. %r/al' batas.rti./e"ler 8elas' P7S ta. /elebar' ta. ta/(a. bat'ta. ta/(a. /assa#

• AORTA ta. ta/(a. /elebar#• Ta. ta/(a. (e/besara% %"li li/2atici (araarta#

• )ESIKA -RINARIA "i%"i%& ta. /e%ebal' re&ler' ta.ta/(a. bat/assa#

•

Ta. ta/(a. e2si (lera#• Ta. ta/(a. caira% bebas i%traab"/e%#

KESAN :

•

$"erate t se@ere hi"r%e2rsis "e.stra e#c bat/lti(le (a"a (el@is .ra% terbesar 1'3+ c/#

• Ta. ta/(a. .elai%a% lai%%5a (a"a r&a% i%traab"/e%(a"a s%&ra9 ab"/e% "i atas#



Res/e

• Telah "i(eri.sa sera%& <a%ita 6 tah%"e%&a% )

– N5eri (i%&&a%& .a%a% se8a. 1 bla%

5a%& lal# N5eri bersi2at hila%& ti/bl"a% "i(erberat 8i.a ber"iri terlal la/a#Ri<a5at .ebiasaa% 8ara%& /i%/ "a%s.a /e%&.%s/si &re%&a%# Per%ah

/e%&ala/i &e8ala ser(a (a"a tah%1** "a% telah se/bh setelah "ibati#

Ter"a(at ri<a5at (e%5a.ithi(er.lesterle/ia "a%



–

Pe/eri.saa% 9si. "ala/ batas %r/al.ecali (a"a (e/eri.saa% ab"/e%ter"a(at %5eri .et. [email protected]%a%#

– Pe/eri.saa% labratri/ saat i%ibel/ "ila..a% %a/% ter"a(atri<a5at hi(er.lesterle/ia "a%hi(ertri&liseri"e/ia#

– Pe/eri.saa% ra"il&i :SG ab"/e%;/e%%8..a% /"erate t se@erehi"r%e2rsis "e.stra e#c bat /lti(le

(a"a (el@is .ra% terbesar 1'3+ c/#



DIAGNOSIS

Balloonin$ Hidron!#rosis !23 N!#rolit,iasis

D!4tra2

TATALAKSANA

Saat i%i' (asie% "iberi.a% bat Na "i.l2e%a. 0 /&"a% /e(rale %t. /e%&ra%&i rasa %5eri (a"a(i%&&a%& .a%a% (asie%#

PROGNOSIS – A" @ita/ ) "bia a" b%a/

– A" 2%cti%a/ ) "bia a" b%a/

– A" /ala/) "bia a" b%a/



Da2tar Psta.a

• Har8a"i Bi"8a8a I# ,011# Anatomi Pelvis# Ja.arta ) EG7# Hal 1*3#

• Sher<" L# ,001# Fisiologi Manusia dari

Sel ke Sistem# Ja.arta ) EG7# Hal 46,0,• G5t%# ,000# Fisiologi Kedokteran#

Ja.arta ) EG7# Pa&e 30+34+#

• Netter FH# ,006# Atlas o Human Anatomy #

4th e"# S ) Sa%"ers# Pa&e 636,,#

• Rasa" S# ,00# Radiologi iagnostik # Ja.arta ) -a"a% Pe%erbit F?I# Hal ,3

,*' ,*+,**' 4*404#



• Pr%/ -# ,011# asar!dasar "rologi# Ja.arta ) Sa&%&

Set# Hal **#• Si"arta H# ,006# Atlas "ltrasonogra# Abdomen $

%ebera&a 'rgan Penting (disi )# Ja.arta ) -a"a% Pe%erbitF?I#

• $e"sca(e# *Hydronerosis and Hydroureter+ #htt()e/e"ici%e#/e"sca(e#c/article436,*#

• S"5 AB# ,00*# %uku A,ar -lmu Penyakit alam# Ja.arta ) F?I# Hal 10,1031#

• Faci AS' -ra%<al" E' ?as(er DL' Haser SL' L%& DL'

Ja/es% JL' Lscal J# ,00# Harrison.s Princi&le od-nternal Medicine /0th edition# Ne< r. ) $cGra<Hill#7ha(ter ,+#

http://emedicine.medscape.com/article/436259

http://emedicine.medscape.com/article/436259

tugas kasus radiologi nefrolithiasis

Documents