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Panduan Praktik Klinis Appendisitis Fix

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  PANDUAN PRAKTIK KLINIS (PPK) TATA LAKSANA KASUSAPPENDISITIS AKUT 1.Pengertian ( Definisi) Apendisitis adalah penyumbatan dan peradangan pada inner lining apendiks vermiformis (usus buntu) dengan jangka waktukurang dari 2 minggu.2.Anamnesis ã  yeri (mula!mula di daerah epigasrium atau umbili al# kemudian menjalar ke titik $ %urney) ã $ual dan atau muntah (rangsang vis eral) ã Anoreksia ã Dapat disertai demam (infeksi akut &.Pemeriksaan 'isik ã tatus generalis tampak kesakitan# demam (*&+#+,-)# fleksi ringan art oae detra ã tatus lokalis yeri tekan $ %urney ã Defen mus ular (/) ã 0ovsing sign (/) ã Psoas sign (/) ã %lumberg sign (/) ã bturator sign (/) ã 0 nyeri searah jam 3!11 ã Peritonitis umum (perforasi) nyeri seluruh abdomen# pekak hati menghilang# bising usus (!) 4. 5riteria Diagnosis  ã $emenuhi kriteria anamnesa ã $emenuhi kriteria pemeriksaan fisik ã kor alvarado 6. Diagnosis 5erjaApendisitis akut7. Diagnosis %anding1.8rolitiasis dekstra2.59&.8: dekstra 4.Adneksitis 6.5ista ovarium terpuntir  7.umor ae um +.Pemeriksaan Penunjang1.8; abdomen 2.D<# P# aP &.8r=-r 4.8< 6.;D 7.es 5ehamilan +.>bsAg ?.ata <aksana indakan operatif  erapi konservatif  <ama perawatan1.perasi dalam bius spinal atau umum 2.pen appendektomi &.@ 4.& hari3.9dukasi = informed onsent (>ospital >ealth Promotion)1.Penjelasan diagnosa# diagnosa banding# pemeriksaan penunjang2.Penjelasan ren ana tindakan# lama tindakan# resiko dan komplikasi&.Penjelasan alternatif tindakan 4.Penjelasan perkiraan lama perawatan1.Prognosis  ã Ad vitam  dubia ad bonam ã Ad sanationam  dubia ad bonam ã Ad fungsionam  dubia ad bonam 11. ingkat 9videns:= II/III/ :B12.ingkat 0ekomendasi A= B =-1&. Penelaah 5ritis1.$' %edah 8mum 2.im >A 0 1414.:ndikator5linis dan laboratorium16. 5epustakaan1.Persatuan dokter spesialis bedah umum :ndonesia. Pedoman pelayanan medik edisi kedua# 27 7!71 2.%rowse <# et all. he symptoms and sign of surgi al disease. 'ourth edition. aylorCfran is group# 26. &.0# De ong Eim. %uku ajar ilmu bedah. 9disi kedua. akarta   penerbit buku kedokteran 9;- 24. 4.;ra e# %orley# At ;lan e:lmu bedah. 9disi ketiga. akarta penerbit 9rlangga# 27.
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