Book Reading Dito

7/25/2019 Book Reading Dito

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KOLITIS ULSERATIF

- BOOK READING-

dr. Ra Aditya Adhi PuruhitaPPDS Ilmu Penyakit Dalam

RSUP Prof.Dr.Sardjito

Pembimbing : dr. Eko Ariwibowo, Sp.PD - KGer



KOLITIS ULSERATIF -DEFINISI-

Chronic

Inflammatory

Bowel Disease

Etiologi belumdiketahui

Hanya pada Colon

Klasifikasi :Distal Disease

More extensive

disease

Pancolitis



KOLITIS ULSERATIF –

EPIDEMIOLOGI-

Lebih sering terjadi dibandingkan Crohn Disease

Insidensi:10 per 100,000

Usia: 1) 15-25 th (paling sering)

2) 55-65 thMale:Female= 1:1

Idiopathic: autoimun yang tercetus karena

infeksi bakteri inflamasi

Genetik: 17 – 35 x resiko lebih tinggi padasaudara kandung yang menderita IBD

1) Ulcerative Colitis; NICE Clinical Guideline (Jun 2013)

http://guidance.nice.org.uk/CG166

http://guidance.nice.org.uk/CG166



KOLITIS ULSERATIF- GEJALA

Diare berdarah

Nyeri perut

Tenesmus

Gejala sistemik : malaise, demam, penurunanberat badan



KOLITIS ULSERATIF -PEMERIKSAAN

FISIK-

Pucat, demam, dehidrasi

Nyeri perut dan tendernes

Distensi Toxic Megacolon

Tanda lain: Takikardia, anaemia dan demamManifestasi ekstraintestinal (1/3 patients)

Proctitis and Proctosigmoiditis

– 50% pasien

– konstipasi 25% pasien



KOLITIS ULSERATIF – CLINICAL

PRESENTATION



KOLITIS ULSERATIF - KLASIFIKASI



KOLITIS ULSERATIF -KLASIFIKASI



KOLITIS ULSERATIF- EXTRA-

INTESTINAL

Aphthous ulcers

Manifestasi pada mata5%Episcleritis

Anterior uveitis

Acute arthropathy pada sendi-sendi besar26%Sacroiliitis

Ankylosing Spondylitis3%

Dermatologi19%Pyoderma gangrenosum

Erythema nodosum

Primary Sclerosing Cholangitis





ULCERATIVE COLITIS-

INVESTIGATIONS

Bloods: FBC, CRP

Stool cultures

Imaging Abdo x-ray-

Barium enema- menggambarkan struktur mukosa

Flexible Sigmoidoscopy and Biopsy- untuk diagnosis



KOLITIS ULSERATIF -

TATALAKSANA

a) Topical aminosalicylatealone (suppository or

enema

) !"## PO

aminosalicylate to a topical

aminosalicylate $%

c) consider an PO

aminosalicylate alone

a) PO "minosalicylate& 'i induction

dose o* an

) !"## topical

"minosalicylate $%

PO eclometasone

dipropionate

- I* no improvement +2rs despite IV

'ydrocortisone $%- ,ymptoms -orsen to

pancolitis.

a) "## IV Ciclosporin to IV

steroids



Indikasi Pembedahan:Tidak berespon terhadap obat-obatan

Mengurangi kualitas hidup secara signifikan

Komplikasi yang mengancam jiwa :

Bleeding

Toxic Megacolon

Impending perforation

Carcinoma

KOLITIS ULSERATIF -

TATALAKSANA



KOLITIS ULSERATIF VS CROHN

DISEASE



Symptoms of Crohn's

Disease

/ Abdominal pain, cramping or

swelling

/ Anaemia

/Fever

/Gastrointestinal bleeding

/Joint pain

/Malabsorption

/Persistent or recurrent

diarrhoea

/Stomach ulcers

/ Vomiting

/Weight loss

Symptoms of Ulcerative

Colitis

/Bloody diarrhoea

/ Abdominal pain or discomfort/ Anaemia caused by severe

bleeding

/Dehydration

/Fatigue

/Fever

/Joint pain

/Loss of appetite

/Malabsorption

/Rectal bleeding

/Urgent bowel movements

/Weight loss

KOLITIS ULSERATIF VS CROHN

DISEASE



Documents

Book Reading Dito