EMERGENCY CASE REPORTS

Tuesday, May 23rd 2023

SURGERY DEPARTMENT

EMERGENCY ROOM
Wahidin Sudirohusodo General Hospital
Makassar
 VISI MISI
PRODI ILMU BEDAH
FK UNHAS
 VISI
Menjadi Pusat Pendidikan Dokter Spesialis Ilmu
Bedah yang setara di tingkat Nasional dan
bereputasi Internasional pada tahun 2025.
 MISI
Menyelenggarakan pendidikan dan pelatihan
Dokter Spesialis Ilmu Bedah untuk menjadi
Dokter Spesialis Ilmu Bedah yang berbudi luhur,
kompeten, inovatif, dan berstandar global.
 MISI
Melaksanakan evaluasi mutu pendidikan secara
berkala dengan senantiasa menyempurnakan
kurikulum pendidikan sejalan dengan perkembangan
dunia dalam ilmu dan teknologi kedokteran.
 MISI
Menyelenggarakan penelitian dasar dan terapan
yang inovatif dan terpublikasi internasional serta
melakukan pengabdian pada masyarakat dalam
bidang Spesialis Ilmu Bedah.
 MISI
Menyelenggarakan kegiatan pendidikan
berkelanjutan untuk menjaga kemampuan
profesional Dokter Spesialis Ilmu Bedah pada
tingkat yang setara di tingkat nasional dan
bereputasi internasional.
EMERGENCY CASE REPORT
Tuesday, May 23th 2023
Ambulation : 1 Patient
Hospitalized
: 11 Patient

Observation : - Patient
Operated : - Patient
Death : - Patient
Total : 12 Patients

Wahidin Sudirohusodo General Hospital

Makassar
 NEW PATIENT’S DATA
SURGERY ER - RSUP WAHIDIN SUDIROHUSODO
Tuesday, March 28th 2023
No. Name Age Gender MR DPJP Diagnosis
Adenocarcinoma Sigmoid Infiltrasi Ovarium + POD 21 Segmented
1 Dorkas 64 F 1015842 dr. IK Sigmoidectomy + HTSOB + POD-15 End Colostomy due to Burst
Abdomen + Leakage Anastomosis
Dyspnea due to Right Pneumothorax Post Chestube D-11 due to
2 Abdul Hamid 61 M 1022359 dr. NA
suspected Lung Tuberculosis + Fistula bronkopleura
3 Ruth Manguma 63 F 1012952 dr. WH Carcinoma Mammae Dextra cT4bN1M0 Karnofsky 70%
4 Yulianti 39 F 1022065 Prof. AAI Tumor intracranial Left Parietal Region
Mild TBI GCS 15 E4M6V5 + falx cerebri Subdural Haemorrhage+
Hematosinus maxillaris bilateral, sphenoidalis bilateral and
5 Hijrah 24 F 1022463 dr. WHY ethmoidalis bilateral + Fracture of multiple os maxillaris bilateral +
dr. SR
Fracture of left suture frontozygomaticum+ Fraktur of os left
zygomaticum
6 Nurhayati 56 F 978717 dr. AZ General weakness due to Anemia + urothelial bladder Carcinoma
Gross hematuria due to prostatic adenocarcinoma with bladder
infiltration post cystostomy + Severe hydronephrosis + hydroureter
7 Arham 55 L 1018416 dr. AP bilateral due to Prostatic Adenocarcinoma + Anemia (Hb 5,2) + CKD
+ Bilateral Pleural Effusion + Hepatitis C infection
8 Marwan 42 L 1019014 dr. WH Cancer pain + Mass of left femur suspected Malignancy
Right Pneumothorax post Chest Tube D-3 + Emphysema Subcutis
9 Bakri 64 L 1022639 dr. JR post multiple incision at ICS II D-3
General Weakness + Anaplastic carcinoma metastatic In the lymph
10 Wahida 48 P 1015337 dr. DJF glands of right neck region Karnofsky 70%
11 Mantasia 40 P 1022642 dr. WH Dyspnea due to susp. Metastasic Lung Cancer + Invasive Left Breast
Carcinoma cT4dN0Mx Karnofsky 70%
12 By Ny Satriani 27 L 1022647 dr. AW Ileus Obstruction due to Susp Hirschsprung Disease
 Name : By. Mrs. S No. Reg : 1022647
Age : 27 Days DPJP : AW

Chief complain : Abdominal Distended

History taking : This condition has been present since 3 days after birth, This
condition gotten worse since 3 days ago. The distention decreased
after defecation. There was no history of nausea, vomiting and fever.
Last defecation is 1 day ago. Micturition is normal
There was no history of surgery
There was history of delayed meconium
Patient was refered from Latemammala Hospital
Pregnancy history : The patient was born by section caesarea with gestational age 39
weeks, birth weight 3100. During pregnancy the mother controls the
ANC routinely at the doctor Clinic and Public Health Center. There was
no herbs consumed during pregnancy. There is history of supplement
consumed during pregnancy.
 Physical Examination

General Status
Moderate Illness / Conscious

Vital Sign
HR : 135 x/mnt, strong, reguler,
RR : 20 x/mnt, symetric L=R.
T(Ax) : 36,5°C

Weight : 3,5 kg

Dehidration Score : 0 (no dehydration)

 Local Status
Abdomen
Inspection : convex, distended, follow breath motion, skin color was the
same with its vicinity, darm contour (+), darm steifung (+)
Auscultation : peristaltic sound was increased.
Palpation : Soefel (+), The Liver and spleen was no palpable
Pecusion : Hyperthympani
 Clinical Diagnosis
• Ileus Obstruction due to Suspected Hirschprung
Disease
Abdomen X-ray
 Laboratory Finding
 HB : 11,3  Na : 142
 WBC : 13.100 K : 4,3
 PLT : 588.000  Cl : 113
 SGOT : 32
 SGPT : 12
 Ur : 20
 Cr : 0.36
 GDS : 108
WORKING : • Ileus Obstruction due to Suspected
DIAGNOSIS Hirschprung Disease

MANAGEMENT : • Asering 200 ml / 24 hrs

• Cefotaxime 175 mg / 12 hrs / iv
• Metronidazole 35 mg / 8 hrs / iv
• Rectal Washout 20cc / kgbb (2x/day)
• Breastfeeding diet
• Consultation with Pediatric

PLAN : • Plan for Rectal Biopsy elective

Thank you