1MOTILITAS USUS HALUS ...............................................................3COLON ..............................................................................................4Colon yang kurang vaskularisasinya, bagian mana?
flexuralienalis .................................................................................................4TARUMA COLON ..............................................................................4COLONIC INJURY SEVERITY ( CIS ) ............................................5ASSOCIATED TRAUMA INDEX ( ATI ) ..........................................5COLOSTOMY ....................................................................................5TRAUMA ABDOMEN .......................................................................6DPL .....................................................................................................8DAMAGE CONTROL .....................................................................12ABSES HATI ....................................................................................15AKUT ABDOMEN ...........................................................................17Lokasi nyeri abdomen ........................................................................ 19POSSIBLE ORIGINS FOR REFERRED PAIN ................................20APPENDICITIS DIFFERENTIATED FROM PELVICINFLAMMATORY DISEASE (PID) ...............................................21 NONSURGICAL CAUSES OF THE ACUTE ABDOMEN ..............21ACUTE ABDOMINAL PAIN ASSOCIATIONS IN THEIMMUNOCOMPROMISED PATIENT .............................................22DIFFERENTIAL DIAGNOSIS OF THE ACUTE ABDOMEN INTHE PEDIATRIC POPULATION .....................................................23CHARACTERIZATION OF DIFFERENT STAGES OFAPPENDICITIS ...............................................................................24ABSES INTRA PERITONIAL (CURRENT) ....................................25INFEKSI INTRA ABDOMINAL ......................................................25PROSES DEFEKASI (SCHWARTZ) ................................................27Sistem Pendarahan Anorectal ...........................................................28HEMORRHOID & PROLAPS RECTI .............................................32Patofisiologi hemorrhoid ...................................................................34PROLAPS RECTI .............................................................................36FISSURA ANI ...................................................................................39FISTULA ANI ...................................................................................44PERIANAL ABSES ..........................................................................48FISTULA GASTROINTESTINAL ...................................................49HERNIA INTERNA ABDOMINAL .................................................51HERNIORAPHY ..............................................................................52HERNIA FEMORALIS .....................................................................53ANATOMI REGIO INGUINALIS ....................................................58HERNIA INSISIONAL .....................................................................61HERNIA OBTURATOR ....................................................................62GAGAL ORGAN PASCA BEDAH ...................................................69SHOCK .............................................................................................69SEPTIC SHOCK ...............................................................................70PERDARAHAN SALURAN CERNA ..............................................72SMBA ...............................................................................................73SMBB ................................................................................................73KLASIFIKASI PERDARAHAN .......................................................76TBC ABDOMINAL ..........................................................................77TPN ...................................................................................................83CAIRAN TUBUH .............................................................................89CEA, AFP, CARCINOID .................................................................90SUTURE MATERIAL .......................................................................91PENJAHITAN USUS ........................................................................93SEPSIS ..............................................................................................95TUMOR GASTER ............................................................................95ABDOMINAL COMPARTMENT SYNDROME .............................. 97TRAUMA SPLEEN ..........................................................................98
2SPLEEN ASCESSORY .....................................................................99ILEUS OBSTRUKSI .........................................................................99Colitis ..............................................................................................101KOLELITHIASIS ...........................................................................104Pankreatitis ......................................................................................107
The Black SabathRevised2
nd
Editiondigestive svrgerybook 1
3
MOTILITAS USUS HALUS
Terdapat 2 jenis pergerakkan/ kontraksi usus halus yaitu :-Segmentasi-Peristaltik Kontraksi segmentasi adalah kontraksi dan relaxasi yang berubahsecara ritmis, berupa kontraksi lokal yang melingkar/ sirkumferinsialdari otot sekunder selebar
±
1 cm. Konstraksi segmental memisahkanisi usus dalam area kontraksi :
Gerakan ritmis ini bertujuan untuk mencampur chyme(campuran makanan dan cairan pencernaan) dan membuatnyakontak dengan mukosa absortif, maka terjadi proses pencernaandan absorpsi.
Pergerakan ini diatur oleh otot polos (miogenik) sehingga tidak tergantung mekanisme saraf.
Aktivitas Ritmik Segmental terjadi dalam usus halus proximaldengan kecepatan konstraksi II konstraksi/ menit, pada usushalus distal : 9 kontraksi/menit.Kontraksi Peristatik
Terdiri dari Konstraksi Intestinal yang bergerak dengankecepatan 1-2 cm/ detik untuk beberapa cm usus.
Peristaltik di bagian distal lebih lambat daripada bagian proximal
Makanan mungkin berperan sebagai stimulus untuk meregangreseptor dalam otot dan mungkin dalam membran mukossa
Gelombang pergerakkan ini menggerakan makanan sepanjangsaluran menuju ke distal.
Konstraksi di belakang bolus ke dalam saluran didepannya.
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