Tiroidektomi merupakan pembedahan yang sering dilakukan di seluruh dunia dengan indikasi pada tumor ganas atau jinak maupun kelainan fungsi tiroid. Pembedahan pada leher sejatinya merupakan prosedur yang berisiko tinggi karena dilakukan pada struktur yang menempel pada pembuluh darah, saraf, dan jalan napas sehingga diperlukan manajemen perioperatif yang baik. Sari pustaka ini bertujuan untuk merangkum berbagai hal yang perlu diperhatikan dalam manajemen terkini perioperatif pembedahan tiroid. Pengelolaan preoperatif mencakup kendali gejala dan tanda hipertiroid atau hipotiroid, puasa, pemberian antibiotik profilaksis, serta manajemen jalan napas. Selama operasi, terdapat hal khusus yang perlu diperhatikan terkait penggunaan obat anestesi, pemantuan hemodinamik, serta upaya pencegahan cedera saraf. Selain itu, beberapa komplikasi pascaoperatif yang perlu dideteksi dan ditangani secara dini, antara lain hipokalsemia, hematoma, cedera nervus laringeus rekurens, kejadian nyeri, mual, dan muntah, serta trakeomalasia. Seluruh tata laksana perioperatif tersebut memerlukan kerjasama multidisiplin.
Most hepatitis A infections are acute, self-limiting, and asymptomatic. In rare instances, extra hepatic complication, such as acute cholecystitis, may emerge. Acute cholecystitis is inflammation of the gallbladder wall and is classified into calculus and acalculus. About 90–95% of cases are brought on by bile duct stones. Acute acalculous cholecystitis can be brought on by structural and functional abnormalities in the gallbladder brought on by viral hepatitis infection. Here we present a 20 years old female patient with acute acalculous cholecystitis associated with hepatitis A infection. Gallbladder distention, thickening of the gallbladder wall, absence of acoustic shadow or biliary sludge, perivesical liquid buildup, and absence of dilatation of the intra- and extrahepatic bile ducts are among the ultrasonographic criteria for diagnosing acute acalculous cholecystitis. The viral hepatitis serology revealed acute hepatitis A infection with positive anti-HAV IgM. Hepatitis A testing should be considered in patients suspected with acalculous cholecystitis of undefined etiology in markedly deranged liver function test adult patients.
Background: Hepatocellular carcinoma (HCC) can arise from either cirrhosis or non-cirrhosis of the liver. HCC in non-cirrhotic livers is still uncommon and can present insidiously in patients. HCC may develop in people with non-cirrhotic chronic liver illness, such as chronic hepatitis B virus infection and chronic HCV infection. More than half of non-cirrhotic individuals with HCC may not exhibit any symptoms, and the disease is frequently detected when it is advanced and incurable. Case Report: Here we presented a 47-year-old man went to the emergency room complaining of upper right side abdominal discomfort that suddenly arose and spread to the back and right shoulder. He also experiencing upper right abdominal fullness for the past two months, along with a sense of a lump growing larger and harder. Hepatic stigmata were not discovered, whole blood revealed a thrombocytosis and significant rising AFP from the expected result of 71,000 ng/dL, with hepatitis B testing was positive. Abdominal ultrasound revealed hepatomegaly and several hypo-hyperechoic nodules. CT scan revealed multiple solid lesions and lytic lesions of the vertebrae bodies. The patient recieved palliative treatment.. Conclusion: This case study demonstrates a non-cirrhotic hepatoma that came at an80 tan advanced stage and was more likely to be asymptomatic than a cirrhotic hepatoma that showed signs of liver failure, such as hepatic stigmata and other physiologic abnormalities. This case report demonstrates the This case study demonstrates the importance of strengthening general HHC preventative measures in order to lower non-cirrhotic HHC's incidence and fatality rate.
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