GEA CASEfr4ft

7/24/2019 GEA CASEfr4ft

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-Case Report-

Acute Gastroenteritis

PRESENTED BY :

REIZKY MUHAR (109170023)

PEDIATRIC DEPARTEMENT

WALED GENERAL HOSPITAL

!"#

CONS$LTANT%

Ir&an Per&ana' Dr(' Sp(A(


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Definition Gastroenteritis

Diarrhea is the passage of unusually loose orwatery stools, usually at least three times in a 24hour period. However, it is the consistency of thestools rather than the number that is mostimportant. Frequent passing of formed stools is

not diarrhoea !H", 2##$%.

2

WHO. The Treatment of Diarrhoea: a Manual for Physicians and Other Senior Health

Workers 2005.


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Epidemiology

!arthin" et al. #cute Diarrhea. World $astroenterolo"y Or"anisation% 200&'


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Inverse association between coverage rates of oral rehydration solution (ORS) use and rates of mortality from diarrhoea in variouscountries

(



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Etiology &auses of diarrhoea with acute onset include thefollowing'

(nfections

Drug)induced

Food allergies or intolerances

Disorders of digestive*absorptive processes

&hemotherapy or radiation)induced enteritis

+itamin deficienciesuandalini -. Diarrhea. vailable from' http'**emedicine.medscape.com*article*/20$/0)followup

1ccesed 2 February 2#33.

5
http://emedicine.medscape.com/article/928598-followuphttp://emedicine.medscape.com/article/928598-followup


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Infectious causes of acute diarrhoea in developed countries

+iruses

)

Guandalini S. Diarrhea. Available from: http://emedicine.medscape.com/article/928598-folloup!Accesed 2" #ebruar$ 2%&&'.
http://emedicine.medscape.com/article/928598-followuphttp://emedicine.medscape.com/article/928598-followuphttp://emedicine.medscape.com/article/928598-followup


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!lassification#cute

*

WHO. The Treatment of Diarrhoea: a Manual for Physicians and Other Senior Health Workers.2005.


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!eces from humans or animals containin" +atho"enic micro,es

or their to-ins

food fluids fin"ers

n"estion of or"anism and/ or to-in

Or"anisms multi+ly and to-in+roduced ,ut infection remain in $

tract

Or"anism inade or to-ins a,sor,ed

dissemination

Sym+toms ofsystemic

infection e-.

!eer etc.

D#1

Patho"enesis of diarrhoea

&


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"athophysiologyosmoticsecretorymala,sor+tioninflammatorydismotility

3Sil,erna"l S and 4an" !. olor #tlas of Patho+hysiolo"y. 6e7 8ork: Thieme% 2003'


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90

htt+://777.7ron"dia"nosis.com/,ookima"es/9)/5(9.9.+n"


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Diagnosis

History : askpresence of blood in

the stool5 duration of diarrhea5number of watery stools per day5number of episodes of vomiting etc.

6hysical e7amination' look and feel Taketemperature

99

WHO. The Treatment of Diarrhoea: a Manual for Physicians and Other Senior Health Workers

2005.


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#oo$ and %eel

92

WHO. The Treatment of Diarrhoea: a Manual for Physicians and Other

Senior Health Workers 2005.


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#aboratoryom+lete ,lood count

9

Guandalini S. Diarrhea. Available from: http://emedicine.medscape.com/article/928598-folloup!Accesed 2"

#ebruar$ 2%&&'.


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Differential Diagnose

ppendicitis(ntussuception&rohn disease(rritable bowel syndrome

9(

Guandalini S. Diarrhea. Available from: http://emedicine.medscape.com/article/928598-folloup!Accesed 2" #ebruar$ 2%&&'.


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&reatment

"8-, iv infusion 9n

:utrition

+itamin ntibiotic

6robiotic

95

WHO. The Treatment of Diarrhoea: a Manual for Physicians and Other Senior HealthWorkers.2005.


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9)


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9*Ionic composition of intravenous infusion solutions

9&


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"revention

!ater, sanitation, and hygiene'-afe food'

&oo;ing eliminates most pathogens from foods

icronutrient supplementation' the effectiveness

of this depends on the child?s overall immunologicand nutritional state5 further research is needed.

vaccines

9&


93


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@eluhan Atama ' Buang air besar cair

8iwayat penya;it se;arang ' pasien datang ;e ;e rumah sa;it dengan

;eluhan buang air besar cair seCa; 3 hari sebelum masu; ;e rumahsa;it, buang air besar dirasa;an terus menerus sebanya; lebih dari4 ;ali dalam sehari dengan volume ;urang lebih 3 gelas tiap ;ali

buang air besar berwarna ;e;uningan, tida; berlendir, tida;berdarah, tida; berbau busu; dan tida; berampas. 6asien Cugamengeluh;an adanya mual dan muntah seCa; 3 minggu sebelummasu; rumah sa;it.

-aat masu; rumah sa;it pasien mengeluh;an sesa; nafas yang hilangtimbul seCa; dua bulan yang lalu, sesa; disertai dengan nyetri dada.6asien tida; mengeluh;an adanya demam, ;eCang dan menggigil.6asien mengata;an nafsu ma;annya yang menurun.

93


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-Case Report-

Acute Gastroenteritis

PRESENTED BY :

REIZKY MUHAR (109170023)

PEDIATRIC DEPARTEMENT

WALED GENERAL HOSPITAL

!"#

CONS$LTANT%

Ir&an Per&ana' Dr(' Sp(A(


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CASE REPORT

Personal Identity( :ame ' -andi :ugraha

(ge ' 34 years old( ender ' >ale

( 8eligion ' (slam

( Father?s name ' !asCan

( ercant( ge ' 4# years old

( >other?s name ' ni Eriani

(


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!'SE RE"OR& &hief complaints' Diarrhea

History of present illness'

6atient came to the hospital with complaints of diarrhea since 3day before hospital admission, the diarrhea continuouslyperceived as much more than 4 times a day with a volume ofappro7imately 3 cup each defecate. yellowish liquid stool, noslimy, no bleeding, no stin;, no pulpy. 6atient also complain of

nausea and vomiting since one wee; before entering thehospital. &urrently hospitalied patients complain of shortness ofbreath intermittent since two months ago, accompanied by chestpain. 6atients did not complain of fever, convulsions and chills.6atients say that declining appetite.


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History of +reious illness


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History of "ro7th and deelo+ment


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PHYSICAL EXAMINATION

Generalized Status:eneral state ' >oderately ill

-ensorium ' fully aware

Vital SignBlood 6ressure ' 33#*G# mmHg

8espiration 8ate ' 24 tpm

Body Eemperature ' ,3 o&

Antropometric Status

Body weight ' 24,$ ;gBody height ' 3$ cm

Nutrition StatusB>(*ge 9)score% ' 3,*34 I )3 Ehin*!asted%


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Head

Local Examination


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Thorax

Local Examination


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Extremit

Local Examination


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RESE

6atient came to the hospital with complaints of diarrhea since one daybefore hospital admission, the diarrhea continuously perceived asmuch more than 4 times a day with a volume of appro7imately onecup each defecate. yellowish liquid stool, no slimy, no bleeding, nostin;, no pulpy.

6atient also complain of nausea and vomiting since one wee; beforeentering the hospital. &urrently hospitalied patients complain ofshortness of breath intermittent since two months ago, accompanied

by chest pain. 6atients did not complain of fever, convulsions andchills. 6atients say that declining appetite, but the symptoms doesn?timprove with this treatment.

Ehese are the findings from physical e7amination. Ehe generalappearance was moderately ill, the level of consciousness wascomposmentis. B6' 33#*G# mmHg, 88' 24 tpm, E' ,3 B>(*' )3wasted%. From the local e7amination, sun;en eyes and dry lips wasfound.


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DI%%ERE*&I'# DI'G*OSE astroenteritis bacterial infection with mild)

moderate dehydration.

astroenteritis viral infection with mild)moderate dehydration.


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Darah rutin

Haemogloin 3,/

!eucocyte 3,2

"rythrocyte 6,4

Hematocrit 41

Platelet $2/

#$H 26

#$H$ 41

#$V 4

%D& $V 334

%D& SD 4#,/

!A'(%A)(%* )"S)ING

%outine 'lood )est

'asophil #

"osinophil 0

!ymphocyte 2

#onocyte G

Segment G

Sta #


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+OR,I*G DI'G*OSE astroenteritis bacterial infection with mild)

moderate dehydration.


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THERAPY

(+FD 8J 32$ ml*;g*h

"ralit 30## ml*hr

mpicilin 2##mg 273 (+

"ndansentron 4mg 373 (+

8anitidin 2$mg 73 (+

J)bio -ach 273 9inc;id 3#mg 273 selama 2 minggu


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EDUCATION

Asing a clean water

&ultivating the habit of washing hands with soapafter defecation and before eating.

Ase a clean bathroom for the whole family

(mproving the nutritional value of food in

sufficient quantity


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"ROG*OSISPrognosis :

) Kuo ad +itam ' d bonam

) Kuo ad Functionam ' d bonam

) Kuo ad -anationam ' d bonam


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)han+ A Huge

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