The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy
Not a member yet
381 research outputs found
Sort by
Dengue Hemorrhagic Fever with Acute Fulminant Hepatitis: A Case Report
No full textDengue virus is estimated to cause over 100 million infections throughout the world annually. Although dengue infections can have a wide range of clinical pictures, atypical manifestations have been described recent years. The liver is a susceptible organ affected in dengue infection. Mild liver dysfunction is common in cases of dengue infection but severe liver function impairment and even encephalopathy are rare. The following is a case report of dengue hemorrhagic fever (DHF) with acute fulminant hepatitis. A 43-year-old woman has fulminant hepatitis on day 3 of treatment. Her AST level increased dramatically from 363 U/L to 3,246 U/L. The causes of other hepatitis infection has been excluded. Her dengue IgM-antibody level was reactive. Level of dengue IgM antibody reactive. Clinical improvement experienced by patient after supportive therapy and administration glisirizin or Stronger Neo-Minophagen-C (SNMC)
Risk Factors Associated with in Hospital Complication Post Gastrointestinal, Pancreatic, Hepatic Cancer Surgery: A Retrospective Case Control Study (RAPHA Study)
Full text linkBackground:This study aims todevelop a scoring system that will predict in-hospital morbidity post gastrointestinal (GI), pancreatic, hepatic cancer surgery in adult patients. This study took place in De La Salle University Medical Center.Method: Two hundred eighty five (285) adult patients 18 years old and above who underwent gastrointestinal, pancreatic and hepatic cancer surgery from 2010 to July 31, 2014 were included. Variables were evaluated in the univariate and multivariate analysis. Calculation of specific score from the resulting factors was performed by logistic regression analysis to develop the scoring system and to determine the best cut-off score in predicting in-hospital morbidity.Results: Out of 142 patients with post-operative complications, factors significantly associated with morbidity were as follows: age ≥ 75 years (p = 0.002), low serum albumin (p = 0.00), abnormal electrocardiogram (ECG) findings (p = 0.036) and emergency surgery (p = 0.000). Calculated best cut-off score was 1.4.Conclusion: The RAPHA scoring system may serve as a promising aid in predicting morbidity and mortality among patients who will undergo GI cancer surgery
First Year Gastrointestinal Endoscopy Profile in Singkawang West Borneo 2017 – 2018
Full text linkBackground: Gastrointestinal endoscopic examination which is included in the referral system of the Badan Penyelenggara Jaminan Sosial (BPJS) has been available at St Vincentius Hospital Singkawang and already been conducted by internist since March 2017 to diagnose upper and lower gastrointestinal diseases. The gastrointestinal endoscopic examination unit serves referrals from Singkawang and its 3 surrounding districts (Sambas, Bengkayang, and Mempawah) that close to the Malaysian border. The purpose of this study is to determine the patients’ profile from Singkawang, Sambas, Bengkayang and Mempawah Districs who underwent gastrointestinal endoscopic examination at St Vincentius Hospital from March 2017 to April 2018.Method: This is a retrospective descriptive study by using secondary data of patient’s medical records at St Vincentius Hospital Singkawang in March 2017 - April 2018. Every patient is included as a sample (total sampling). Total numbers are consisted of 308 patients including 230 esophagogastroduodenoscopies and 78 colonoscopies.Result: The results of this study showed that majority of patients were more likely to undergo esophagogastroduodenoscopy (EGD) (75%) than colonoscopy (25%). Males, age group of 51-70 years old and Malay ethnic are the groups of patients who have the most upper and lower gastrointestinal disorders. The prominent finding of esophagogastroduodenoscopy was erosive gastritis (64%), whereas internal hemorrhoids was the most common finding in colonoscopy (67%); if internal hemorrhoids was excluded, colon mass became the most common finding disorder.Conclusion: Patient were mostly male, age group between 51 – 70 years old and Malay. The most common finding in colonoscopy (67%); if internal hemorrhoids was excluded, colon mass shifted forward as the top finding disorder
Antibiotic Associated Diarrhea in Hospitalized Adult Patients
Full text linkBackground: Antibiotic associated diarrhea (AAD) occurs from the first initiation until 2 months of the end of antibiotic treatment. The aims of this study were to know the incidence of AAD, Clostridium difficile infection and other gastrointestinal symptoms in hospitalized adult patients.Method: The study is a cross sectional study. We studied the antibiotic associated diarrhea (AAD), Clostridium difficile infection and other gastrointestinal symptoms in patients who were admited in Cipto Mangunkusumo Hospital. Inclusion were male or female, age 18-75 years old, Patients started receiving antibiotics maximal 2 x 24 hours prior to hospitalization, gave written informed consent.Results: The incidence of AAD was 11.5%. The incidence of Clostridium difficile infection was 15.4%. The Upper gastrointestinal symptom was present on 20 (38.5%) patients. Lower abdominal symptom was present on 10 (19.2%) patients.Conclusion: The Incidence of AAD and Clostridium difficile infection were 11.5% and 15.4% respectively. The clinical manifestations of AAD were diarrhea, other upper and lower abdominal symptoms.
Acute Cholangitis: An Update in Management Based on Severity Assessment
Full text linkAcute cholangitis (AC) is a biliary tract emergency which causes significant morbidity and mortality. The direct cause of death in AC is sepsis that leads to irreversible shock and multiple organ failure. The most common predisposition are bile duct stones and previous invasive manipulation of the biliary tree. Biliary infection and biliary obstruction are the two main factors in pathophysiology of AC. Gram-negative bacteria are isolated frequently from bile and blood culture in cholangitis. The most common cause of biliary obstruction is gallstone.The Charcot’s triad which commonly has been used to diagnose AC is severely limited and the clinical presentation of the disease has wide spectrum ranging from mild symptoms to severe life-threatening disease. Thus, the use of the most updated Tokyo Guidelines (TG18) is imperative to diagnose the disease and to assess the severity. The TG18 diagnostic criteria is based on the presence of systemic inflammmation, cholestasis, and evidence on imaging studies of biliary tract. The prompt treatment is tailored according to severity assessed by TG18. Initial treatment includes sufficient fluid replacement, hemodynamic control, electrolyte compensation, intravenous antibiotic administration, and intravenous analgesic administration. The definitive treatment which related to the pathophysiology of the disease are biliary drainage and antibiotic administration
Effects of Curcumin against Matrix Metalloproteinase-2 (MMP-2) and Tissue Inhibitor Metalloproteinase-2 (TIMP-2) Serum Level on Rat Model of Liver Fibrosis Resolution Process
Full text linkBackground: Liver fibrosis is an effect from continuous fibrogenesis and fibrolysis process. During fibrogenesis, MMP-2 and TIMP-2 that produced by hepatic stellate cell (HSC) have a role to regulate extracellular matrix (ECM) homeostastic. Otherwise, curcumin inhibits both MMP-2 and TIMP-2 expression and enhances HSC apoptosis, thus inhibit fibrogenesis. Role of curcumin, MMP-2, and TIMP-2 in a fibrolysis process has not been widely studied. This study aimed to determine the correlation between curcumin administration and the decline of MMP-2 and TIMP-2 on rat model of liver fibrosis.Method: This is an experimental study done in male Wistar rats. There are 8 groups consist of 4 rats each. Both control and intervention group were exposed to CCl4 1 cc/kgBW intraperitoneally 2 times per week for 9 consecutive weeks to form F3 fibrosis. Negative control group was injected with normal saline. After CCl4 injection, control group was given curcumin solvent as placebo while intervention groups were given curcumin 200 mg/kgBW for 2, 5, and 9 weeks. Statistical analysis then conducted in the end of study. Results: MMP-2 and TIMP-2 were remarkably increased in positive control group, but found decreased in control group 5 and 9. There are remarkable decrease of MMP-2 and TIMP-2 serum level in intervention group 2, 5, and 9, but MMP-2 and TIMP-2 level was significantly lower in intervention group 2 compared to the control group.Conclusion: MMP-2 and TIMP-2 serum level were decreased after giving of curcumin for 2 weeks. The duration of curcumin administration correlated with decrease of TIMP-2 serum level but not correlated with MMP-2 serum level in rat model of liver fibrosis
Association Between Red Cell Distribution Width (RDW)/Platelet Ratio and Degree of Fibrosis in Patient with Chronic Hepatitis B
Full text linkBackground : Histological examination of the liver remains the gold standard of assessing liver cirrhosis. However, this examination is an invasive method with many complications.Objectives : This study aims to determine the relationship between degree of liver fibrosis with RDW (Red cell Distribution Width) / platelet ratio which can then be used as non invasive diagnostic method of liver fibrosis. Methods : This was a retrospective study, the data of hematological profiles including hemoglobin, RDW, and platelet was taken from medical records of all chronic hepatitis B patients undergoing Fibroscan at Sanglah Hospital in January 2016 to February 2017. Results : Of 58 patients, 9 patients was excluded due to chronic kidney disease, malignancy and coincide with hepatitis C and HIV. The analysis using Kruskal-Wallis test, found a significant relationship between RDW / platelet ratio with degree of fibrosis in chronic hepatitis B (p<0.05). Of the 49 patients, 23 patients with mild-moderate fibrosis (metavir F0-2) and 26 patients with severe fibrosis (metavir F3-4) were found. In ROC analysis, the AUC was 0.701, using cut off 0,065 RDW/platelet ratio predict severe fibrosis about 73.1% sensitivity, spesificity 73.9%, positive prediction value 73.1%, and negative prediction value 70.8%. Conclusion : the RDW / platelet ratio can be used as a noninvasive diagnostic test of liver fibrosis in chronic hepatitis B patients
Intralesion Triamcinolon Injection Therapy on Esophageal Stricture as Side Effect of Long Term Use Biphosphonate
Full text linkSystemic Lupus Erythematous (SLE) is a chronic inflammatory disease that affect almost any organ system. Patient with SLE is at risk of osteoporosis. Biphosphonate is one of osteoporosis treatments. However, esophageal stricture (ES) caused by continuous esophageal inflammation as a result of long-term use Biphosphonate can occur. Intralesion Triamcinolone Injection (ITI) becomes one of ES therapy by inhibiting inflammatory response to injury and decrease subsequent collagen formation. ITI inhibits transcription of matrix protein genes, including fibronectin and procollagen. It also reduces the synthesis of α2-macroglobulin, an inhibitor of collagenase activity. A 43 year old woman was diagnosed with SLE. She was treated with Risedronic Acid (bisphosphonate class) 35 mg once a week. After 8 months, she started complaining difficulty to swallow. Symptom was getting worse 6 months later. One-third distal ES with inflammation process was found with endoscopy. ITI 150 mg was given in inflammation area. She was scheduled to follow up after 7 days for re-endoscopy. Endoscopy showed that inflammation process had been improved. Six months later, she had again complained difficulty to swallow and we found that she still consumed Risedonic Acid. ITI 150 mg was given because inflammation and ES was found with endoscopy. After 7 days, endoscopy showed that there was no ES and inflammation process had been improved. She was advised to stop Risedronic Acid consumption
Hepatocellular Carcinoma (HCC) Surveillance – Comprehensive Management in Liver Cirrhosis Patients
Full text linkPrimary Biliary Cirrhosis
Full text linkPrimary biliary cirrhosis (PBC) is an inflammatory disease or chronic liver inflammation, with slow progressive characteristic and is an unknown cholestatic liver disease and commonly happen in middle-aged women. The incidence of PBC is 0.03 – 5.8 per 100,000 people per year, prevalence of 1.91-40.2 per 100,000 people and continues to increase. Based on the American Association for Study of Liver Disease criteria, the diagnosis of PBC is made in the presence of two out of three criteria, which are increase of alkaline phosphatase, positive antimitochondrial antibodies (AMA), and histopathology examination.We reported a case which is very rarely found; a 47-year-old women with the chief complaints of decrease consciousness and jaundice. In physical examination, there were anaemic conjunctiva, icteric sclera, hepatosplenomegaly, palmar erythema, and liver nails. In the patient, there was no evidence of obstruction in imaging with two-fold increase of alkaline phosphatase and positive AMA test. Patient was hospitalised to slow down the progression of the disease and to overcome the signs (e.g. pruritus, osteoporosis and sicca syndrome)