Hematemesis Melena et causa Ulkus Peptik

Hematemesis Melena et causa Ulkus Peptic

Kelompok PBL C3:

Terry Reniban (102010352) Joceline Valencia (10201302) !n"ra #$r %n&&i (10201'01) Polikarp$ %ri*in (10201'0') ( 10201'0') Jane La$ra (10201'122) Kar+ika ,e-i (10201'220) .abriel /eekia (10201'221)

ak$l+a Ke"ok+eran ni4eri+a Kri+en Kri"a acana acana Jalan %r6$na +ara #o708 Jakar+a Bara+ 11510 Ta$n Pembela6aran 20159201

Abstrak 

/ema+emei (m$n+a "ara) "an melena mer$pakan kea"aan yan& "iakiba+kan ole  per"araan al$ran cerna ba&ian a+a (CB%)7 %"a empa+ penyebab CB% yan& palin& erin& "i+em$kan8 yai+$ $lk$ pep+ik$m8 &a+ri+i eroi*8 4arie eo*a&$8 "an r$p+$r m$koa eo*a&o&a+rika7 ,i ne&ara bara+ ini"eni per"araan ak$+ CB% mencapai 100 per 1007000  pen"$"$k9+a$n8 laki;laki lebi banyak "ari -ani+a7 T$6$an pen$lian 6$rnal ini a"ala $n+$k  memaami "e*inii8 e+iolo&i8 pa+o&enei "an cara men"ia&noi ema+emei melena er+a men&e+a$i al&ori+ma pena+alakanaan "an komplikai ema+emei "an melena7 Ka+a K$nci: ema+emei8 melena

 Abstract 

 Hematemesis (vomiting blood) and melena is a condition caused by upper gastrointestinal  bleeding. There are four causes of upper gastrointestinal bleeding most common, namely  peptic ulcer, erosive gastritis, esophageal varices, and rupture esofagogastrika mucosa. In western countries the incidence of upper gastrointestinal bleeding reached 1 per 1, inhabitants!year, men more than women. The purpose of writing this paper is to understand  the definition, etiology, pathogenesis and diagnosis of hematemesis melena way and to know the algorithm and the management of complications hematemesis and melena.  "eywords# hematemesis, melena

Pendahuluan

/ema+emei (m$n+a "ara) "an melena (B%B "ara) mer$pakan kea"aan yan& "iakiba+kan ole per"araan al$ran cerna ba&ian a+a ($pper &a+roin+e+inal +rac+)7 Kebanyakan ka$ ema+emei a"ala kea"aan &a-a+ "i r$ma aki+ yan& menimb$lkan %!#

cyclooi&enae 27

beker6a

"en&an

men&amba+

enim

cyclooi&enae

1

"an

Fnim Cyclooy&enae ber*$n&i eba&ai pemeca aam araki"ona+

men6a"i pro+a&lan"in "an +rombokan7 Pro+a&lan"in a"ala molek$l peran+ara pera"an&an7 elain i+$ pro+a&lan"in a"ala molek$l pro+ek+i* $n+$k m$koa lamb$n&7 Pen&ar$  pro+a&lan"in

+era"ap

lamb$n&

a"ala

men$r$nkan

ekrei

aam

lamb$n&

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menin&ka+kan ekrei m$k$ pa"a m$koa lamb$n&7 Jika +er6a"i amba+an "alam pro"$ki  pro+a&lan"in8 maka memperbear +er6a"inya ker$akan pa"a m$koa lamb$n&7 Karena m$k$ yan& berk$ran& "an aam lamb$n& yan& banyak "ipro"$ki7 ,an al ini +er6a"i pa"a  paien yan& men&&$nakan oba+;oba+an an+iin*lamai non +eroi"7 F*ek ampin& oba+ an+i in*lamai non +eroi" (>%!#)

pa"a al$ran cerna +i"ak +erba+a pa"a lamb$n&7 F*ek 

ampin& pa"a lamb$n& meman& palin& erin& +er6a"i7 >%!# mer$ak m$koa lamb$n& melal$i "$a mekanime8 yai+$ +opikal "an i+emik7 Ker$akan m$koa ecara +opikal +er6a"i karena >%!# beri*a+ aam "an lipo*ilik8 ein&&a memperm$"a trapping ion hydrogenma$k m$koa "an menimb$lkan ker$akan7 F*ek i+emik >%!# +ampaknya lebi pen+in& yai+$ ker$akan m$koa +er6a"i akiba+ pro"$ki pro+a&lan"in men$r$n8 >%!#

ecara bermakna menekan pemben+$kan pro+a&lan"in7 Pro+a&lan"in "ipro"$ki melal$i "$a  6al$r yai+$ 6al$r Co1 "an 6al$r Co27 eper+i yan& "ike+a$i8 pro+a&lan"in mer$pakan $b+ani i+opro+ek+i* (yan& beraal "ari Co1) yan& ama+ pen+in& ba&i m$koa lamb$n&7 F*ek i+opro+ek+i* i+$ "ilak$kan "en&an cara men6a&a aliran "ara m$koa8 menin&ka+kan ekrei m$koa "an ion bikarbona+8 "an menin&ka+kan ephitelial defense7 Pro+a&lan"in yan& "iben+$k "ari 6al$r Co2 menimb$lkan in*lamai8 nyeri8 "an "emam8 ein&&a >%!# yan& elek+i* men&amba+ Co2 rela+i* lebi aman "i&$nakan7%liran "ara m$koa yan& men$r$n menimb$lkan a"ei ne+roli+ pa"a en"o+el pemb$l$ "ara m$koa "an memac$ lebi 6a$  proe im$nolo&i7 Ra"ikal beba "an pro+eae yan& "ilepakan akiba+ proe im$nolo&i +ereb$+ akan mer$ak m$koa lamb$n&7  5

Diagnosis anding Kelainan di esophagus Pecanya 4arie eopa&$ Per"araan 4arie ecara ka +er6a"i men"a"ak "an mai*8 keilan&an "ara &a+roin+e+inal

kronik 6aran& "i+em$kan7 Per"araan 4arie eo*a&$ a+a$ lamb$n& biaanya "iebabkan ole iper+eni por+al yan& +er6a"i ek$n"er akiba+ iroi epa+i7 ?ekip$n iroi alkoolik  mer$pakan penyebab 4arie eo*a&$ yan& palin& pre4alen "i %merika erika+8 e+iap kea"aan yan& menimb$lkan iper+eni por+al "apa+ men&akiba+kan per"araan 4arie7 Lebi lan6$+8 ken"a+i a"anya 4arie berar+i a"anya iper+eni por+al yan& $"a berlan&$n& lama8  penyaki+ epa+i+i ak$+ a+a$ in*il+rai lemak yan& eba+ pa"a epar ka"an&;ka"an& menimb$lkan 4arie yan& akan men&ilan& be&i+$ abnormali+a epar "iemb$kan7 ?ekip$n per"araan ?B% pa"a paien iroi $m$mnya beraal "ari 4arie eba&ai $mber per"araan8 k$ran& lebi epar$ "ari paien ini "apa+ men&alami per"araan yan&  beraal "ari $lk$ pep+ik$m a+a$ &a+ropa+i iper+eni por+al7 Kea"aan yan& "ieb$+ +erakir  ini +er6a"i akiba+ pen&&emb$n&an 4ena;4ena m$koa lamb$n&7 eba&ai konek$eninya8 an&a+ pen+in& menen+$kan penyebab per"araan a&ar penan&anan yan& +epa+ "apa+ "iker6akan57 %n&ka ke6a"ian pecanya 4arie eopa&$ yan& menyebabkan per"araan c$k$p +in&&i yai+$ 5'8ba+ penekan in+ea aam lamb$n& (PP!) 27 Ta+alakana K$$ Terapi me"ikamen+oa PP! (proton pump inhibitor) : oba+ an+i ekrei aam $n+$k mence&a per"araan $lan&7 ,ia-ali "oi bol$ >mepraol ba+;oba+an lain yan& 6$&a "apa+ menimb$lkan ema+emei yai+$ : &olon&an kor+iko+eroi"8 b$+aoli"in8 reerpin8 pironolak+on "an lain; lain7

Daftar Pustaka

17 %+era8 ! 7?7 G ! ,7#7 iba-a7 Ta+a Lakana Per"araan al$ran ?akan Ba&ian %+a : "alam .a-a+ ,ar$ra+ "i Bi"an& Penyaki+ ,alam7 Jakar+a: F.CI 2007p7 53D  27

27 Ric+er8 J7?7 G K7J7 !elbacer7 Per"araan al$ran ?akanan: "alam /arrion (Prinip !lm$ Penyaki+ ,alam) Jili" !7 Jakar+a: F.CI 20037p7 25D27 37 Bickley L7 Te ab"omen7 !n: Bickley L8 e"7 Ba+e &$i"e +o pyical eamina+ion an" i+ory +akin&8 < + e"7 Lippinco++ illiam G ilkin: #e- orkI 20027p7 31;7 '7 epe P8 acimki P8 rie"man L7 .a+roen+erolo&y7 !n: aba+ine ?8 e"7 Pocke+ me"icine8 3r" e"7 Lippinco++ illiam G ilkin: Pila"elpiaI 200