A 78 YEARS OLD WOMAN WITH HEPATIC CIRRHOSIS

Riyan Wahyudo

Abstract


Hepatic chirrosisis a patological condition that show end stage od hepatic fibrosis and moves progressively that signed with distortion of hepar arsitecture and makes regenerative nodulus. This appearance was happened because of hepatocellular necrosis. A woman, 78 years old, came with a chief complaint of big stomach since 1 months ago, feel fullness and pain during 2 days and become more intense until offend daily activities. She also felt tight, nausea, vomitting, decreasing body weight, and swelling on her feet. The urine looks like a thick tea and the feces looks like a black coal. He had been diagnosed with “yellow sickness” 3 years ago. From physical examination, he was compos mentis with blood pressure 160/100 mmHg, pulse 80x/mnt, respiration rate 14x/mnt, temperature 36,8oC, pretibialis oedema, conjungtiva pale, icteric sclera, ronkhi in pulmo auscultation. In abdominal examination, there was simetrical appearance, distention, tight, pain, abdominal diameter 105cm. From laboratory examination, the LED was 30,3 mm/hour, trombosit 134.000/ul (normal: 150.000-400.000/ul), GDS 394 mg/dl (normal: 70-200mg/dl), ureum 26 mg/dl, creatinin 0,96 mg/dl, SGOT 29 u/l, Gamma GT (GGT) 264 u/l, Total Bilirubin 1,11 mg/dl, Direct Bilirubin 0,47 mg/dl. Medikamentosa therapy is given Spironolakton 1 x 100 mg, Furosemid injection 1 ampul/ 24 injection, Sukralfat syrup 3xC1, Ranitidin injection 1 ampul/ 12 jam, Vitamin K 1 x 1, Bisoprolol 1 x 1, Humulin injection 6-6-6 IU, Amlodipin 1 x 10 mg. Chirrosis hepatic in this pasien is because ofhepatitis B.

Keywords: hepatitis B, hepatic chirrosis, oedem, shifting dullness.

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