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BAGIAN ILMU BEDAH
REFERA
FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN UNIVERSITAS TADULAKO
PERIAPENDIKULAR INFILTRAT
Oleh: AYU AYU PUSPITA PU SPITA SARI, S.Ked (N 111 14 075)
Pem!m!"#: d$. I %ADE &IRKA, S'.
Sign up to vote on this title AIAN IL%U EDA*
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FAKULTAS KEDOKTERAN UNI+ERSITAS TADULAKO RU%A* SAKIT U%U% DAERA* UNDATA
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DAFTAR ISI
*ALA%AN SA%PUL................................ SA%PUL....................................................... .............................................. .................................. ...........
DAFTAR DAFTAR ISI....................................... ISI.............................................................. .............................................. ............................................ .....................
PENDA*ULUAN............................. PENDA*ULUAN...... .............................................. .............................................. .............................................. ....................... TIN/AUAN PUSTAKA A. . . D. E. F. .
A"2m!.................................... A"2m!........................................................... .............................................. ..................................... .............. F!3!2l2#!..................................... F!3!2l2#!............................................................ .............................................. ..................................... .............. E!2l2#!..................................... E!2l2#!............................................................ .............................................. ...................................... ............... P2!3!2l2#!............................ P2!3!2l2#!.............................. ........................................... ............................................................ ................. %"!e33! %"!e33! 6l!"!3........................................ 6l!"!3............................................................... ......................................... .................. D!#"23!3.................................. D!#"23!3......................................................... .............................................. ....................................1 .............1 Pe"l63"".................. Pe"l63""......................................... .............................................. ........................................1 .................1
PENUTUP... PENUTUP.......................... .............................................. .............................................. .............................................. ....................................18 .............18
DAFTAR DAFTAR PUSTAKA................... PUSTAKA.......................................... .............................................. .............................................. .........................1 ..1
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Periapendikular infilra adala! infla"a#i di appendik# aau "ikr$perf$ra
%an& diuupi aau di 'un&ku# $le! $"enu" dan aau lekuk u#u# !alu# aa peri$neu" #e!in&&a er'enuk #uau "a##a()
Ma##a periapendikular adala! #ala! #au k$"plika#i %an& #erin& erdap
pada pa#ien #eela! 'e'erapa !ari "en&ala"i appendi#ii# aku( Ma##a appendi
le'i! #erin& er*adi pada pa#ien u#ia li"a a!un aau le'i! karena da%a a!an u'u
ela! 'erke"'an& den&an 'aik dan $"enu" ela! +ukup pan*an& dan e'al unu "e"'un&ku# pr$#e# radan&(
,
Ri-a%a kla#ik apendi#ii# aku. %an& diikui den&an adan%a "a##a %an
n%eri di re&i$ iliaka kanan dan di#erai de"a". "en&ara!kan dia&n$#i# ke "a# aau a'#e# periapendikuler( Ge*ala kla#ik apen#i#ii# aku 'ia#an%a 'erupa n%eri daera daera! ! u"'i u"'ili liku ku## aau aau periu periu"' "'il ilik iku# u# %an& %an& 'er! 'er!u' u'un un&a &an n den& den&an an "un "un
Ke"udian n%eri 'erali! k kuadran kanan. %an& akan "eneap dan di per'era 'il
'er*alan aau 'auk( Terdapa Terdapa *u&a kelu!an an$rek#ia. "alai#e. dan de"a" %an idak erlalu in&&i( )
Append Appendi#i i#ii# i# dapa dapa die"u die"ukan kan pada pada #e"ua #e"ua u"ur. u"ur. !an%a !an%a #a*a pada pada ana
kuran& dari #au a!un *aran& dilap$rkan( In#iden#i erin&&i pada kel$"p$k u"u ,/01 ,/01/ / a!u a!un. n. #eel #eela! a! iu "enu "enuru run( n( In#i In#ide den# n#ii pada pada laki laki0la 0laki ki dan dan pere" pere"pu pu u"u"n%a #e'andin&( )
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Not useful Useful Belu" ada ke#e"pakaan pendapa anara para a!li dala" pen&el$laa
"a##a apendi#ii#. #e!in&&a di dapakan pendapa %an& k$nr$2er#ial(
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,( Mela Melaku kuka kan n $per $pera# a#ii !an% !an%aa pada pada "a## "a##aa apen apendi dik# k# %an& %an& "$'il $'ile. e. den& den&
peri"'an&an $pera#i dapa le'i! "uda! diker*akan karena pr$#e# 3-allin $ff4 'elu" #e"purna( 1( Melakukan Melakukan erapi erapi k$n#er2aif k$n#er2aif er!ada er!adap p "a##a apendik apendik## %an& erfik#ir erfik#ir.. den
pe"'erian ani'i$ik dan $'#er2a#i kea 'ila &a&al dan er'enuk a'#e# "ak dilakukan draina#e den&an aau anpa apendek$"i( Bila 'er!a#il pa#ien pulan&kan den&an pe#an daan& ke"'ali ke"'ali unuk appendek$"i iner2al(
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A. ANA ANATO%I Lu"enn%a #e"pi di 'a&ian pr$k#i"al dan "ele'ar di 'a&ian di#a
Na"un de"ikian. pada 'a%i. appendik# 'er'enuk keru+u. le'ar pad
pan&kaln%a dan "en%e"pi ke ara! u*un&n%a( Keadaan ini "un&kin "en*a #e'a' renda!n%a in#iden appendi#ii# pada u#ia er#e'u( )
Appendik# 2er"if$r"i# erleak di re&i$ ilia+a de5ra. dan u*un&n%
dipr$%ek#ikan dipr$%ek#ikan ke dindin& dindin& aneri$r aneri$r a'd$"en a'd$"en pada iik #eperi&a #eperi&a 'a-a! &ar
%an& %an& "en&!u "en&!u'un 'un&ka &kan n #pina #pina ilia+a ilia+a aneri aneri$r $r #uperi #uperi$r $r dan u"'ili+ u"'ili+u# u# 6i M+Burne%7(1
Hu'un&an anara da#ar apendik# dan +ae+u" eap k$n#an ea
u*un& appendik# dapa di e"ukan rer$+ae+al. pel2i+. #u'+e+al. preileal. aa kanan peri+$li+a(8
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Areria appendi+ulari# "erupakan +a'an& areri ile$+ae+ali# 6+a'an a("e#e a("e#en ner eri+a i+a #upe #uperi$ ri$r7( r7( Arer Arerii appe append ndik ikul ulari ari## "eru "erupa paka kan n areri areri a
k$laeral(
"aka appendik# akan "en&ala"i &an&ren( ( Aliran dara! 'alik %aiu "elal
2ena appendikulari# "en&alirkan dara!n%a ke 2ena ile$+ae+al. ke"udia "enu*u 2ena "e#enerika #uperi$r dan "a#uk ke #irkula#i p$ral( 1
=a'an&0+a'a =a'an&0+a'an& n& #araf #i"pai# 6ner2u# 6ner2u# !$ra+ali# !$ra+ali# >7 dan para#i"pa
6ner2u# 2a&u#7 dari ple5u# "e#eneri+u# #uperi$r( Sera'u #araf aferen %an
"en&!a "en&!ana narka rkan n ra#a n%eri n%eri 2i#+era 2i#+erall dari dari append appendik# ik# 2er"if 2er"if$r" $r"i# i# 'er*al 'er*al
'er#a"a #araf #i"pai# dan "a#uk ke "edulla #pinali# #ein&&i 2ere' !$ra5i+a >( Ole! karena iu. n%eri 2i#+eral pada appendi#ii# 'er"ula #ekiar u"'iliku#().1
. FISI FISIOL OLO OII Apendik# "en&!a#ilkan lendir #e'an%ak )0, "L per !ari( Lendir i
n$r"aln%a di+ura!kan kedala" lu"en dan #elan*un%a "en&alir ke #eku"
Ha"'a Ha"'aan an aliran aliran lendir lendir di "uara "uara apendi apendik# k# 'erper 'erperan an dala" dala" pa$&e pa$&ene# ne# apendi apendi#i #ii#( i#( I"un$& I"un$&l$' l$'uli ulin n #ekre #ekre$ar $ar %an& %an& di!a#il di!a#ilkan kan $le! $le! GALT GALT 6
a##$+iaed l%"p!$id i##ue7 %an& erdapa di #aluran +erna. er"a#uk apendik
iala! iala! I&A( I&A( I"un$& I"un$&l$' l$'uli ulin n iu #an&a #an&a efeki efekiff #e'a&a #e'a&aii pelind pelindun& un& er!ada er!ada
infek#i( Na"un de"ikian. pen&an&kaan apendik# idak "e"pen&aru!i #i#e i"un i"un u'u u'u! ! kare karena na *u"l *u"la! a! *ari *arin& n&an an li"f li"f$i $id d di#i di#ini ni ke+i ke+ill #eka #ekali li Sign up to vote on this title
) di'andin&kan denan *u"la! n%a di#aluran +erna dan di#eluru! u'u!( Useful Not useful
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"en%e'a'kan apendi#ii# adala! er$#i "uk$#a apendik# aki'a para#i #epe E. Histolytica( Histolytica()., Peneli Peneliian ian epide" epide"i$l i$l$&i $&i "enun* "enun*ukk ukkan an peran peran ke'ia#a ke'ia#aan an "ak renda renda! ! #era #era dan dan pen& pen&aru aru! ! k$n# k$n#i ipa pa#i #i er! er!ad adap ap i"'u i"'uln ln%a %a apen apendi di K$n#ipa#i K$n#ipa#i akan "enaikkan "enaikkan ekanan inra#ekal. inra#ekal. %an& 'eraki'a i"'u
#u"'aan #u"'aan fun&#i$nal fun&#i$nal apendik# apendik# dan "enin&kan% "enin&kan%aa peru"'u!a peru"'u!an n ku"an ku"an fl$ k$l$n() D. PATOFISI OFISIOLO OLOI I Pa$ Pa$l$ l$&i &i apen apendi di#i #ii i## dapa dapa di"u di"ula laii di "uk$ "uk$#a #a dan dan ke"u ke"u
"eli'akan #eluru! lapi#an din#in& apendi# dala" -aku ,808? *a" pera"
Tekanan di dala" #eku" akan "in&in&ka *ika kaup ile$#ekal k$"pee
K$"'ina#i ekanan in&&i di #eku" dan penin&kaan fl$ra ku"an di k$l$
aki'a #e"'eli "en*adi pen+eu# radan& di "uk$#a apendik#( Pen+eu# la
iala! er$#i dan ukak ke+il dia di #elapu lendir $le! E( Hi#$l%i+a da
pen&!a"'aan e2akua#i i#i apendik#( E2akua#i ini er!a"'a $le! #en$#
aau pen%u"'aan lu"en aau &an&&uan "$ilia# $le! pia aau ad!e#i da
fak$r lain %an& "en&uran&i &erakan 'e'a# apendik#( Perke"'an&an da
apendi#ii# "uk$#a "en*adi apendi#ii# k$"pli %an& "elipui #e"ua lapi#a
dindin& apendik# enu dipen&aru!i $le! 'er'a&ai fak$r pen+eu# #ee"p
%an& "en&!a"'a pe&$#$n&an lu"en apendik# aau "en&&an&&u "$ilia n$r"al apendik#() Pa$fi Pa$fi#i$l #i$l$&i $&i da#ar da#ar append appendi#i i#ii# i# adala! adala! $'#ru $'#ruk#i k#i lu"en lu"en append append %an& %an& diik diikui ui $le! $le! infek infek#i( #i(
Sign up to vote on this title O'# O'#ru ruk# k#ii lu"e lu"en n appe append ndik ik## "en% "en%e'a e'a'k 'k Useful Not useful
peru"'u!an 'akeri %an& 'erle'i!an dan pr$duk#i "uku# %an& eru "eneru "eneru## #e!in&& #e!in&&aa er*adi er*adi di#en di#en#i #i inral inralu"i u"inal nal dan penin& penin&ka kaan an ek
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#e!in&&a er'enuk "a##a periapendikular( Didala"n%a dapa er*adi nekr$#
*arin&na 'erupa a'#e## %an& dapa "en&ala"i perf$ra#i(
enan& dan #elan*un%a akan "en&urai diri #e+ara la"'a( ) Pada "a##a periapendikuler den&an pe"'enukan dindin& %an& 'elu
#e"purna. dapa er*adi pen%e'aran pu# ke #eluru! r$n&&a peri$neu" *ik
perf$ra#i diikui $le! peri$nii# purulena &enerali#aa() Gan&ren dan perf$ra#i k!a# dapa er*adi dala" ,8019 *a". api -ak
er#e'u dapa 'er'eda 'eda #eiap pa#ien karena di enukn 'an%ak fk$r( Bi
#ekre#i "uku# eru# 'erlan*u. ekanan akan eru# "enin&ka( Hal er#e'
akan akan "en%e' "en%e'a'k a'kan an $'#ru $'#ruk#i k#i 2ena. 2ena. ede"a ede"a 'era"' 'era"'a! a! dan 'akeri 'akeri aka ak "ene"' "ene"'u# u# dindin dindin& &
apendi apendik#( k#( Peradan& Peradan&na na i"'ul i"'ul "elua# "elua# dan "en&
peri$neu" #ee"pa #e!in&&a "eni"'ulkan n%eri di daera! akanan 'a-a
Keadaan ini di#e'u den&an appendi#ii# #upuraif aku( Bila ke"udian are
er&an&&u akan er*adi infark dindin& apendik# %an& diikui den&na &na&ren
Sadiu" ini di#e'u den&an apendi#ii# &an&ren$#a( Bila dindin& %an& ela
rapu! iu pe+a!. akan er*adi apendi#ii# perf$ra#i( Bila #e"ua pr$#e# dia
'er*alan la"'a. $"enu" dana u#u# %en& 'erdekaan akan 'er&erak keara
apendik# !in&&a i"'ul #uau "a##a l$kal %an& di#e'u infilra apendikulalri Peradan&an aaapendik# er#e'u dapa "en*adi a'#e# aau "en&!ilan Infilra Infilra apendikual apendikualri# ri# "erupakan "erupakan a!ap pa$l$&i pa$l$&i apendi#ii# apendi#ii# %an& di"ula
"uk$#a dan "eli'akan #eluru! lapi#an dindin& apendik# dala" -aku ,808
*a" pera"a. ini "erupakan u#a!a pera!anan u'u! den&na Sign up to vote on this title "e"'aa Useful $"enu". Not useful pr$#e# radan& den&an "enuup apendik# den&na u#u# !alu#.
adnek#a #e!in&&a er'enuk "a##a periapendikular(
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Ke+epa Ke+epaan an renea renean n peri#i peri#i-a -a er#e'u er#e'u er&an er&anun un& & pada pada 2irule 2irule
"ikr$$r&ani#"e. da%a a!an u'u!. fi'r$#i# pada dindin& apendik#. $"enu"
u#u# lain. peri$neu" parieale.dan *u&a $r&an lain #eperi 2e#ika urinari
u'a uerina. "en+$'a "e"'aa#i dan "el$kali#i#r pr$#e# peradan&na in
@alaupun pr$#e# "el$kali#ir #uda! #ele#ai eapi "a#i! 'elu" +ukup ku
"ena!an a!anan aau e&an&na dala" +a2u" a'd$"inali#. $le! akrena i
penderia a!ru# 'enar0'enar i#ira!a 6'edre#7( Apendik# a%&n perna! radan
idak akan #e"'u! #e"purna. eapi akan "e"'enuk *arin&na paru %an
"en%e'a'kan perlen&kean den&na *arin&an #ekiarn%a( Perlen&kean ini aka "eni"' "eni"'ulk ulkan an kelu!a kelu!an n 'erula 'erulan& n& di peru peru kanan kanan 'a-a!( 'a-a!( Pada Pada #uau #uau ke
$r&an ini akan dapa "eradan& ke"'ali dan din%aakan #e'&ai ek#a#er'a aku()
E. %ANIFE %ANIFEST STA ASI KLINIS KLINIS Appen#i Appen#i#i #ii# i# infil infilra ra dida!u dida!ului lui $le! $le! kelu!a kelu!an n apendi apendi#ii #ii## aku aku %an
ke"udian ke"udian di#erai adan%a "a##a periapendik periapendikular ular(( Ge*ala kla#ik apend
aku 'ia#an%a 'er"ula dari n%eri di daera! u"'iliku# aau periu"'iliku# %an
'er!u'un&an den&an "una!( Dala" ,0), *a" n%eri 'erali! ke kuadra
kanan. %an& akan "eneap dan di per'era 'ila 'er*alan aau 'auk( Terdap
*u&a kelu!an an$rek#ia. "alai#e dan de"a" %an& idak erlalu in&&
Bia#an%a *u&a erdapa k$n#ipa#i eapi adan& kadan& er*adi diare. "ual da
"una!( Pada per"ulaan i"'uln%a pen%aki 'elu" ada kelu!an a'd$"e
%an& "eneap( Na"un dala" 'e'erapa *a" *a "Sign n%eri a'd$"en kanan up to vote on this title 'a-a! aka
Useful Not useful #e"akin pr$&re#if(9 Appendik# %an& erleak rer$#ekal rer$peri$neal 6anara #eku" da
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ran&# ran&#an an&a &an n #i&"$ #i&"$id id aau aau re+u re+u" " #e!in #e!in&& &&aa peri peri#a #al li# i# "enin "enin&k &ka a
pen&$#$n&an re+u" "en*adi le'i! +epa #era 'erulan&( Appendik# %an "ene"pel "ene"pel ke kandun& ke"i! dapa "eni"'ulkan "eni"'ulkan d%#uria dan penin&ka frekuen#i frekuen#i ken+in& ken+in& aki'a ran&#an&an appendik# appendik# er!adap er!adap dindin& dindin& kandu ke"i!().
F. DIA DIANO NOS SIS a( Ana"ne#i# Pada ana"ne#i#. kelu!an ua"a appendi#ii# 'ia#an%a adala! n%e
#a"ar0#a"ar dan u"pul %an& "ula0"ula dira#akan di epi&a#riu" aa
re&i$ u"'ili+al %an& diiukui den&an an$rek#ia dan "ual( N%eri ke"udia
dira#akan 'erpinda! ke peru kanan 'a-a!. epan%a di iik M+Burne
Selain iu erdapa pula kelu!an "una!. $'#ipa#i. dan fe'ri#( Na"u
kelu!an %an& dira#akan pa#ien appendi#ii# dapa 'er'eda $le! karen
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Useful peru Not useful ini "erupakan kun+i dia&n$#i#( Padapenekanan kiri 'a-a! aka
dira#akan n%eri di peru kanan 'a-a& %an& di #e'u r$2#in& #i&n( Pad
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inraper2ika inraper2ikall "aka "a##a dapa dira'a pada re+al $u+!er #e'a&ai "a#
%an& !an&a( Peri#alik u#u# #erin& n$r"al. peri#alik dapa !ilan& karen
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'a-a!( Ga"'aran per#elu'un&an "un&kin erli!a ileal aau #ekal ileu
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appendi#ii# appendi#ii# aku "e"iliki "e"iliki #en#ii2ia# #en#ii2ia#Sign dari ::09; ::09 dantitle #pe#ifi#ia# ? up to vote ; on this
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m$ P22"#" l2"#!9d!l" d" 63!l me"9"966" ''e"d!63 e$e"96 99l$ d" d!3e"3! m'6 d!"d!"# h!'2e;h2!; me"9"966" !"lm3! 'e"d!63.
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:
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T 3;" d2me", <"# me"9"966" 'e"el" d!"d!"# ''e"d!63, meme$! m'6" $#e 3!#" (A), d!3e"3! ''e"d!63 de"#" ;!$" 'e$!''e"d!;el 'e$!''e"d!;el ()
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klini# klini# appendi#ii# appendi#ii# aku "a#i! "un&kin "un&kin #ala! pada #ekiar #ekiar ):0,/; ):0,/; ka#u Unuk Unuk "enuru "enurunka nkan n an&ka an&ka ke#ala! ke#ala!an an dia&n$ dia&n$#i# #i# append appendi#i i#ii# i# aku. aku. dia&n$ dia&n$#i# #i# "era&u "era&ukan kan.. #e'aik #e'aikn% n%aa pender penderia ia di$'#e di$'#er2a r2a#i #i di ru"a! ru"a! den& den&an an freku frekuen en#i #i #eia #eiap p )0, )0, *a"( *a"( Pe"e Pe"eri rik# k#aan aan ulra ulra#$ #$n$ n$&r &raf afii da "enin&kakan akura#i dia&n$#i#()
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Leuk$#i$#i#
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Hiun& *eni# leuk$#i shift leuk$#i shift to the left
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Bila dia&n$#i# klini# #uda! *ela#. indakan palin& epa dan "erupaka
#au0#aun%a pili!an %an& 'aik adala! appendek$"i( ) Pa#ien den&an ri-a%
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piuria7 dan *u"la! leuk$#i %an& in&&i den&an per&e#eran ke kiri 'ia#an% ida idak k "e"e "e"erlu rluka kan n #udi #udi pen+ pen+i iraa raan n a"'a a"'a!a !an n #e'e #e'elu lu" " appe append ndek ek$ $
Pe"'eda!an *u&a diindika#ikan pada pa#ien den&an pre#ena#i aipikal da
e"uan radi$&rafi radi$&rafi %an& k$n#i#en den&an appendi#ii#( appendi#ii#( Seiap pa#ien den&
n%eri peru aipikal %an& "e"iliki 6)7 n%eri per#i#en dan "en*adi de"a". 6
penin&kaan *u"la! leuk$#i. aau 617 e"uan pe"erik#aan klini# "e"'uru !aru# "en*alani lapar$#k$pi dia&n$#ik dan u#u# 'unu( )) Mana&e" Mana&e"en en 'eda! 'eda! pada pada "a##a "a##a apendi apendikul kular ar "a#i! "a#i! k$nr$ k$nr$2er 2er
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penilaian %an& 'erkelan*uan er!adap perke"'an&an pa#ien( Terdapan% Te rdapan% Sign up to vote on this title
a'#e# a'#e# apendi apendik# k# a!ru# a!ru# dilaku dilakukan kan drina# drina#e e #ela"a #el a"a f$ll$f$ll$-up. up. append appendek ek Useful Not useful
elekif di rek$"enda#ian #eela! er*adi re#$lu#i "a##a apendik#( Bia#an%
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Ma##a apendik# 'erfaria#i dari fle&"$n #a"pai a'#e# dan ini er'enu
,;09; ,;09; ka#u# ka#u# %an& %an& di a-ali a-ali den&n den&naa apendi apendi#ii #ii## aku( aku( Pada Pada ka#u# ka#u# a'# apendi apendik# k# %an& %an& *ela# *ela# idak idak erdapa erdapa k$nr$ k$nr$2er 2er#i #i er!ad er!adap ap "ana&e" "ana&e"en en
Opera#i draina#e #e&era 6perkuaneu# aau $pen7 adala! aalak#ana pili!a $le! $le! #e'a& #e'a&ia ian n 'e#ar 'e#ar #pe# #pe#ial iali# i# 'eda 'eda!( !( Unu Unuk k fle& fle&"$ "$n. n. dapa dapa dila dilaku ku
'e'erapa pendekaan aalak#ana pili!an dari k$n#er2aif #a"pai a&re#
Terdapa i&a pendekaan %an& p$puler dilakukan unuk aalak#ana "a## apendi apendik#( k#( a7 erapi erapi k$n#er2 k$n#er2aif aif diiku diikuii den&an den&an apende apendek$ k$"i "i iner2 iner2al al "in& "in&&u &u ke"ud ke"udian ian.. '7 apen apende dek k$" $"ii #e&era #e&era *ika *ika erda erdapa pa re#$l re#$lu# u#ii "a
infla"a#i. +7 k$n#er2aif #e+ara ke#eluru!an anpa apendek$"i iner2al pad
pa#ien den&an "a##a apendik#()1 Ma#ala! 'a&i a!li 'eda! adala! *ika pederia die"ui #eela! 8? *a" a!li 'eda! 'eda! akan akan "en&$p "en&$pera# era#ii unuk unuk "e"'ua "e"'uan& n& apendi apendik# k# %an& %an& "u
&an&rene dari dala" "a##a perlen&kean rin&an %an& l$n&&ar dan #an& 'er'a!a%a. dan 'ila"ana karena "a##a ini ela! el a! "en*adi le'i! erfik#a#i 2a#kula 2a#kular. r. #e!in&& #e!in&&aa "e"'u "e"'ua a $pera#i $pera#i 'er'a! 'er'a!a% a%aa "aka "aka !aru# !aru# "enun& "enun&
pe"'enukan a'#e# %an& dapa "uda! di draina#e( Ma##a periapendikul %an& %an& "a#i! "a#i! 'e'a# 'e'a# di#aran di#arankan kan #e&era #e&era di$pera di$pera#i #i unuk unuk "en+e& "en+e&a! a! pen%u pen%u
Selain iu $pera#i le'i! "uda!( Pada anak diper#iapkan $pera#i dala" -ak ,01 ,01 !ari !ari #a*a( #a*a( Pada Pada pa#ie pa#ien n de-a de-a#a #a den& den&an an "a##a "a##a peri periap apen endi diku kular lar %a
'erdindin& #e"purna di an*urkan unuk dira-a da!ulu dan di'eri ani'i$
#a"'il di a-a#i #u!u u'u!. ukuran "a##a. #era lua#n%a peri$nii#( Bi Sign up to vote on this title
#uda! idak ada de"a". "a##a periapendikular dan leuk$#i n$r"a useful Useful!ilan&. Not
penderia '$le! pulan& dan apendik$"i elekif dapa diker*akan ,01 'ula
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Per#iapan dan pe"'eda!an !aru# dilakukan #e'aik0'aikn%a # e'aik0'aikn%a "en&in&
pen%uli infek#i luka le'i! in&&i dari pada pe"'eda!an pada apendi#i
#eder!ana dan anpa perf$ra#i( Pada periapendikular infilra dilaran& kera
"e"'uka peru. indakan 'eda! apa'ila dilakukan le'i! #uli dan perdara!a le'i! le'i! 'an%ak. 'an%ak. erle'i erle'i! ! *ika *ika "a##a "a##a apendi apendik k ela! ela! er'en er'enuk uk le'i! le'i! dari
"in&&u #e*ak #eran&an #aki peru( Pe"'eda!an dilakukan #e&era 'ila dala pera-aan er*adi a'#e# den&an aaupun anda peri$nii# u"u"( Te
#e"ena #e"enara ra unuk unuk ?0), ?0), "in&&u "in&&u adala! adala! k$n#er2 k$n#er2aif aif #a*a( #a*a( Pada Pada anak anak ke+
-ania !a"il. dan penderia u#ia lan*u. *ika #e+ara k$n#er2aif idak "e"'a
aau 'erke"'an& "en*adi a'#e#. di an*urkan $pera#i #e&era( Bila pada -ak
"e"'uka "e"'uka peru erdapa periapendikual periapendikualrr infilra infilra "aka luka $pera#i $pera#i di uu
la&i. apendik# di'iarkan #a*a( )1
dilakukan #eela! 90? "in&&u ke"udian(
&e*ala apapun dan pe"erik#aan *a#"ani dan la'$ra$riu" idak "enun*ukka
anda anda radan& radan& aau aau a'#e#. a'#e#. #an&a #an&a di peri" peri"'an 'an&ka &kan n "e"'aa "e"'aalka lkan n indak indak
'eda!( Anal&e#ik di 'erikan !an%a kalau perlu #a*a( O'#er2a#i #u!u dan nad Bia#an% Bia#an%aa 8? *a" akan akan "ereda "ereda(( Bila Bila &e*ala &e*ala "en&!e "en&!e'a 'a andan andan%a %a er*
perf$ra#i "aka !aru# diperi"'an&kan apendek$"i( Baa# dari "a#
!endakn%a di 'eri anda 6de"$&rafi7 #eiap a!ri( Bia#an%a pada !ari ke :0
"a##a "ulai "en&e+il dan erl$kali#ir()1
Sign up to vote on this title !aru# #e&era di 'uka unuk di draina#e( =ara den&an "e"'ua in#i#i pad Useful Not useful
dindin& peru #e'ela! laeral di"ana n%eri ekan adala! "ak#i"u" 6in+i &rid &rid ir$n7( ir$n7( A'#e# A'#e# di+apa di+apaii #e+ara #e+ara ek#rap ek#raperi eri$ne $neal. al. 'ila 'ila apendi apendik# k# "uda! "uda!
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A III PENUTUP A. KE KESI SI%P %PUL ULAN AN Peri Periap apen endi diku kula larr
infi infil lra ra
adal adala! a!
infl infla" a"a# a#ii
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u#u# u#u# !alu# !alu# aau peri$n peri$neu" eu" #e!in& #e!in&&a &a er'en er'enuk uk #uau #uau "a##a "a##a Appen Appen#i#i #i#i infil infilra ra dida!u dida!ului lui $le! $le! kelu!a kelu!an n apendi apendi#i #ii# i# aku aku %an& %an& ke"udi ke"udian an di#e adan%a "a##a periapendikular( Mana&e" Mana&e"en en 'eda! 'eda! pada pada "a##a "a##a apendi apendikul kular ar "a#i! "a#i! k$nr$ k$nr$2er 2er
Penan&anan n$n $peraif a-al di kenalkan $le! $+!#ner pada a!un )/)( H
ini "elipui F re&i"en 6O+!#ner0S!erren Re&i"en7. F$-ler P$#i#i$n. Fluid '% "$u! aau inra2ena. F$ur !$url% aau le'i! #erin&. # erin&. $'#er2a#i nadi dan
#e!ari ukur #u!u. Feel. palpa#i "a##a apaka! "en&e+il aau "akin "e"'e#a
Fun&i. ani'i$i+. F$r'idden anal&eik( "a##a periapendikular %an& 'erdindin& #e"purna di an*urkan unu
dira-a dira-a da!ulu da!ulu dan di'eri di'eri ani'i$ ani'i$ik ik #a"'il #a"'il di a-a#i a-a#i #u!u #u!u u'u!. u'u!. ukura "a## "a##a. a. #er #eraa lua# lua#n% n%aa peri peri$n $ni ii# i#(( Bila Bila #uda #uda! ! ida idak k ada ada de" de"a". a". "a periapendikualr !ilan&. dan leuk$#i n$r"al. penderia '$le! pulan&
apendik$"i elekif dapa diker*akan ,01Sign 'ulan up toke"udian vote on this a&ar title perdara!a
Useful aki'a perlen&kean dapa diekan #ek+il "un&kin(
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)( S*a"#u!ida*a S*a"#u!ida*a R( U#u# U#u# Halu#. Apendi Apendik#. k#. K$l$n. K$l$n. dan An$reku An$reku" " Apendi Apendi
Ver"if$r" r"if$r"i#( i#( In S*a"#u! S*a"#u!ida ida*a *a R. Karnad Karnadi!a i!ard*a rd*a @. T!edde T!eddeu# u# OH Rudi"a Rudi"an n Ren$( Ren$( Buku Buku A*ar Il"u Il"u Beda! Beda! S*a"#u! S*a"#u!ida ida*a *a0de 0de<$n <$n&( &( 1 rd
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