Laporan Kasus - Chronic Venous Insufficiency (Nyoman Aditya Sindunata)

LAPORAN KASUS CHRONIC VENOUS INSUFFICIENCY 

Pembimbing : dr. Nyoto Widyo Astoro, Sp.PD-KHOM, FINASIM

Disusun Oleh : Nyoman Aditya Sindunata FK UPH - !""!#"!!# !""!#"!!#

KEPANITERAAN KLINIK ILMU PENYAKIT DALAM PERIODE 23 MEI – 6 AGUTU 2!"6 RUMA# AKIT PUAT ANGKATAN DARAT GATOT OE$ROTO %AKULTA KEDOKTERAN UNI&ERITA PELITA #ARAPAN 'AKARTA

LEM$AR PENGEA#AN KOORDINATOR KEPANITERAAN DEPARTEMEN DEPARTEMEN ILMU PENYAKIT PENYAKIT DALAM D ALAM

L()*+(n ,(sus -eng(n .u-ul: Chronic Venous Insufficiency

Disusun un/u, Memenuhi 0(+(/ Mengi,u/i U.i(n Ke)(ni/e+((n Klini,  De)(+/emen Ilmu Pen0(,i/ D(l(m Rum(h (,i/ Pus(/ Ang,(/(n D(+(/ G(/*/ *eb+*/* '(,(+/(

Disusun *leh:  N0*m(n A-i/0( A-i/0( in-un(/( %KUP# 2!""!1" 2!""!1"!!12 !!12

$%&a' dis%tu(ui o&%' P%m)im)in*+ Nama P%m)im)in*

$anda tan*an

dr. dr. Nyoto Nyoto W. A., Sp. PD-KHOM, PD-KHOM, FINASIM FINASIM .......... ............... .......... .......... .....

$an**a&

.......... ............... .....

M%n*%ta'ui K%pa&a D%part%m%n I&mu P%nyait Da&am RSPAD atot So%)roto aarta

dr. H. Sya/ruddin A. R. L%&osutan, Sp.PD-K0H, MARS, FINASIM

KA$A KA$A P0NAN$AR  P0N AN$AR 

Pu.i s0u,u+ )en0usun )(n.(/,(n ,eh(-i+(/ Tuh(n Y(ng M(h( Es( ,(+en( (/(s be+,(/ -(n +(hm(/N0( )en0usun (,hi+n0( -()(/ men0eles(i,(n )en0usun(n l()*+(n ,(sus -eng(n .u-ul Chronic Venous Insufficiency4 Insufficiency4 Tu.u(n -(+i )enulis(n l()*+(n ,(sus ini (-(l(h un/u, memenuhi /ug(s -(n s0(+(/ s0(+(/ -(l(m -(l(m menem) menem)uh uh ,e)(ni/ ,e)(ni/e+(( e+((n n ,lini, ,lini, -i De)(+/e De)(+/emen men Pen0( Pen0(,i/ ,i/ D(l(m D(l(m Rum(h (,i/ Pus(/ Ang,(/(n D(+(/ G(/*/ *eb+*/* '(,(+/(4 Pen0usun Pen0usun men0(-(+i men0(-(+i b(h5( )en0usun(n )en0usun(n l()*+(n ,(sus ini b(i, -(+i segi isi -(n b(h(s(n0( s(ng(/ .(uh -(+i sem)u+n(4 T(n)( b(n/u(n -(n bimbing(n -(+i  )ih(, l(in suli/ +(s(n0( b(gi )en0usun un/u, men0eles(i,(n l()*+(n ,(sus ini *leh ,(+en( i/u )en0usun men0(m)(i,(n u()(n /e+im( ,(sih ,e)(-( -+4 N0*/* 7i-0* -0*

As/* s/*+*

)4PDK#OM

%INA INAIM

(/( (/(s

bimb imbing(nn0( n0(

-(l(m l(m

men0eles(i,(n l()*+(n ,(sus ini4 A,hi+n0 A,hi+n0(( )en0us )en0usun un be+h(+( be+h(+() ) l()*+( l()*+(n n ,(sus ,(sus ini -()(/ -()(/ be+m(n be+m(n8((/ 8((/ b(gi b(gi semu( semu( )ih(,4 )ih(,4 Pen0usu Pen0usun n .ug( .ug( be+h(+ be+h(+() () men-() men-()(/, (/,(n (n ,+i/i, ,+i/i, -(n s(+(n s(+(n 0(ng 0(ng memb(ngun un/u, ,esem)u+n((n )en0usun(n l()*+(n ,(sus ini4

'(,(+/( "! 'uli 2!"6

Pen0usun

DAF$AR ISI

L%m)ar P%n*%sa'an....................... P%n*%sa'an.............................................. ..................................................................... .................................................i ...i Kata P%n*antar....................... P%n*antar.............................................. .............................................. ........................................................ii .................................ii Da/tar Isi...................................... Isi............................................................. .............................................. ...................................................iii ............................iii 1a) I P%nda'u&uan................................................................................................" 1a) I Laporan Kasus.................................................... Kasus........................................................................... ......................................... .................. I.

Id%ntitas Pasi%n.................................... Pasi%n........................................................... .............................................. ................................. ..........

II.

Anamn%sis............................ Anamn%sis................................................... .............................................. ................................................ .........................

III.

P%m%risaan Fisi...................................... Fisi............................................................. ..................................... ....................... .........2 2

I3. I3.

P%m%risaan P%nun(an*............................. P%nun(an*...................................................................... .............................................4 ....4

3.

R%sum%............................ R%sum%................................................... .............................................. ................................................... ............................ "!

3I.

Da/tar Masa&a'............................. Masa&a'.................................................... .......................................................... ................................... "!

3II.

Dia*nosis K%r(a................................. K%r(a........................................................ .................................................... ............................. "!

3III.

P%nata&asanaan................ P%nata&asanaan....................................... .............................................. ....................................... ...................."" ....""

I5.

Pro*nosis...................... Pro*nosis............................................. .............................................. ....................................................."" ..............................""

5.

$inda Lan(ut.................................. Lan(ut......................................................... .............................................. .................................."" ...........""

5I.

P%n*a(ian.......................... P%n*a(ian................................................. .............................................. .............................................."6 ......................."6

1a) III $in(auan Pustaa.............................. Pustaa..................................................... ................................................... .............................." .." I.

Anatomi dan Fisio&o*i 3%na........................ %na............................................... .............................................." ......................."

II.

Pato/isio&o*i......................... Pato/isio&o*i................................................ ..................................................................... .............................................. 

III.

Mani/%stasi Mani/%stasi K&inis......................................... K&inis................................................................ ..........................................2 ...................2

I3. I3.

Dia*nosis.............................. Dia*nosis..................................................... .............................................. .............................................7 ......................7

3.

Dia*nosis 1andin*.................................. 1andin*......................................................... ..................................................8" ...........................8"

3I.

$ata&asana...... $ata&asana............................. .............................................. ............................................................. .........................................8 ...8

1a) I3 P%nutup...................................................................................................87 Da/tar Pustaa............................. Pustaa.................................................... ...................................................................... ............................................... ..84

1A1 I P0NDAHULUAN

Chronic venous insufficiency  insufficiency  9&I; me+u)(,(n )en0(,i/ ,+*ni, -im(n( /e+-() /e+-()(/ (/ g(nggu g(nggu(n (n )(-( )(-(

3@1 4!,!

36@ 48,"

,"4?

,26?

",#8?

33 2 21 ! "2!

-e/i,  "!2 – "22 -e/i, 

-e/i,  2>! – @!2 -e/i, 

 3? U=L  @! U=L 2! – ?! mg=-L !? – "? mg=-L  "@! mg=-L

9e5(,/u; Urina&isis 7(+n( Ke.e+nih(n $e+(/ 'enis  )# P+*/ein Glu,*s( $ili+ubin  Ni/+i/ Ke/*n U+*bilin*gen D(+(h Leu,*si/

"1:!6 Kuning 'e+nih "4!"? 6! =Neg(/i8 =Neg(/i8 =Neg(/i8 =Neg(/i8 =Neg(/i8 !" =Neg(/i8 =Neg(/i8

Kuning 'e+nih "!"! – "!3! @6 – ! Neg(/i8   Neg(/i8   Neg(/i8   Neg(/i8  Neg(/i8   !" – "! mg=-L Neg(/i8   Neg(/i8  

Es/e+(se e-imen U+in E+i/+*si/ Leu,*si/ ilin-e+ K+is/(l E)i/el

!!! "!" =Neg(/i8 =Neg(/i8 =P*si/i8  

 2 =LP$  ? =LP$ Neg(/i8 =LPK   Neg(/i8   P*si/i8 

L(in  l(in

" =Neg(/i8  

5-ray %nu 1i&at%ra& 9!:!4:"4<

#(sil : • • •

Ke-u-u,(n /ul(ng/ul(ng genu b(i,4 Ti-(, /(m)(, sublu,s(si m(u)un -isl*,(si4 Ti-(, /(m)(, 8+(,/u+ *bs/+u,si lesi li/i, = bl(s/i,4

• •

Densi/(s /ul(ng b(i,4 T(m)(, *s/e*8i/ -i *n-0lus me-i(l -(n l(/e+(l 8emu+ bil(/e+(l -(n *n-0lus  )+*,sim(l me-i(l -(n l(/e+(l *s /ibi( bil(/e+(l b(sis -(n ()e,s )(/ell(

• • •

 bil(/e+(l4 T(m)(, T(m)(, en/hes*8i/ -i eminen/i( in/e+*n-0l(+is bil(/e+(l4 el(h sen-i 8em*+*/ibi( men0em)i/ -ise+/(i s,le+*/i, /ibi(l )l(/eu sisi me-i(l T(m)(, T(m)(, *ssi8i,(si -i su)+()(/ell(+4

Kes(n : OA Genu bil(/e+(l g+(-e III -eng(n sus)e, s0n*