<p>Perforasi saluran gastrointestinal melibatkan organ lambung, duodenum, usus kecil, atau usus besar terjadi akibat kerusakan dinding saluran gastrointestinal disertai pelepasan konten intraluminal ke dalam rongga peritoneal atau retroperitoneal. Perforasi saluran gastrointestinal merupakan keadaan darurat medis umum dengan angka kematian tinggi; biasanya membutuhkan pembedahan darurat. Diagnosis dan pengobatan segera sangat penting untuk mengurangi morbiditas dan mortalitas. Foto polos abdomen dapat menjadi bantuan penting untuk diagnosis perforasi saluran gastrointestinal. Ultrasonografi dapat berguna untuk menentukan tidak hanya keberadaan, tetapi juga penyebab pneumoperitoneum. <em>Multidetector computed tomography</em> merupakan modalitas pilihan untuk evaluasi dugaan perforasi karena sensitivitas dan akurasinya yang tinggi.</p><p> </p><p>Perforation of the gastrointestinal tract involves organs of the stomach, duodenum, small intestine, or large intestine that result from damage of the gastrointestinal tract accompanied by intraluminal content release into the peritoneal or retroperitoneal cavities. Gastrointestinal perforation is a common medical emergency associated with high mortality; usually requires emergency surgery. Prompt diagnosis and treatment is essential. Plain abdominal radiographs can be an important aid for diagnosis gastrointestinal perforation. Ultrasound can also be used to determine not only the presence, but also the cause of pneumoperitoneum. Multidetector computed tomography is the modality of choice for the evaluation of suspected perforation because of its high sensitivity and accuracy. </p>
Perforasi saluran gastrointestinal melibatkan organ lambung, duodenum, usus kecil, atau usus besar terjadi akibat kerusakan dinding saluran gastrointestinal disertai pelepasan konten intraluminal ke dalam rongga peritoneal atau retroperitoneal. Perforasi saluran gastrointestinal merupakan keadaan darurat medis umum dengan angka kematian tinggi; biasanya membutuhkan pembedahan darurat. Diagnosis dan pengobatan segera sangat penting untuk mengurangi morbiditas dan mortalitas. Foto polos abdomen dapat menjadi bantuan penting untuk diagnosis perforasi saluran gastrointestinal. Ultrasonografi dapat berguna untuk menentukan tidak hanya keberadaan, tetapi juga penyebab pneumoperitoneum. Multidetector computed tomography merupakan modalitas pilihan untuk evaluasi dugaan perforasi karena sensitivitas dan akurasinya yang tinggi. Perforation of the gastrointestinal tract involves organs of the stomach, duodenum, small intestine, or large intestine that result from damage of the gastrointestinal tract accompanied by intraluminal content release into the peritoneal or retroperitoneal cavities. Gastrointestinal perforation is a common medical emergency associated with high mortality; usually requires emergency surgery. Prompt diagnosis and treatment is essential. Plain abdominal radiographs can be an important aid for diagnosis gastrointestinal perforation. Ultrasound can also be used to determine not only the presence, but also the cause of pneumoperitoneum. Multidetector computed tomography is the modality of choice for the evaluation of suspected perforation because of its high sensitivity and accuracy.
Abstract Introduction: The prompt initiation of appropriate antifungal therapy is essential in controlling invasive candidiasis and improving the prognosis in critical patients undergoing treatment in the Intensive Care Unit. Candida Score can assess patients at risk of candidiasis and is expected to assist clinicians in starting antifungal therapy in patients suspected Candidiasis. The purpose of this study was to determine the pattern of antifungal administration in critically ill patients with candidiasis in the Intensive Care Unit at Sanglah General Hospital. Patients and Methods: The design of this study is a cross-sectional descriptive study involving critically ill patients who were under treatment in Intensive Care Unit of Sanglah General Hospital from Januari to June 2019. The patients included in this study were patients who were ≥ 18 years old and under treatment in ICU for at least 7 days. Results: There are 64 patients undergoing treatment in the Intensive Care Unit. From 64 patients, 6 pasien had CS = 0, 29 patients had CS = 1, 13 patients had CS = 2, 11 patients had CS = 3, 5 patients had CS = 4, and no patients had CS = 5. Eleven patients received empirical antifungal therapy. All empirical antifungal therapies use the Triazole group. Conclusion: In this study was found that 11 of 16 patients with a CS value of ≥ 2.5 were given empirical antifungal therapy, while 48 patients with a CS value of <2.5 were not given empirical antifungal therapy. Keywords: Invasive Candidiasis, Candida Score, Empirical Antifungal Therapy.
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