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CONSULTANT:
Irman Permana, Dr., Sp.A.
PRESENTED BY :
REIZKY MUHAR (109170023)
PEDIATRIC DEPARTEMENT
WALED GENERAL HOSPITAL
2015
Definition Gastroenteritis
Diarrhea is the passage of unusually loose or
watery stools, usually at least three times in a 24
hour period. However, it is the consistency of the
stools rather than the number that is most
important. Frequent passing of formed stools is
not diarrhoea (WHO, 2005).
WHO. The Treatment of Diarrhoea: a Manual for Physicians and Other Senior Health
Workers 2005.
Epidemiology
Inverse association between coverage rates of oral rehydration solution (ORS) use and rates of mortality from diarrhoea in various
countries.
following:
Infections
Drug-induced
Food allergies or intolerances
Disorders of digestive/absorptive processes
Chemotherapy or radiation-induced enteritis
Vitamin deficiencies
Classification
Acute
WHO. The Treatment of Diarrhoea: a Manual for Physicians and Other Senior Health Workers.2005.
food
fingers
fluids
DIARE
Symptoms of
systemic
infection ex.
Fever etc.
Pathogenesis of diarrhoea
Pathophysiology
dismotility
inflammatory
malabsorption
secretory
osmotic
9
Silbernagl S and Lang F. Color Atlas of Pathophysiology. New York: Thieme, 2009;
10
http://www.wrongdiagnosis.com/bookimages/16/5413.1.png
11
Diagnosis
History : ask presence of blood in
the stool; duration of diarrhea;
number of watery stools per day;
number of episodes of vomiting etc.
Physical examination: look and feel
Take temperature
WHO. The Treatment of Diarrhoea: a Manual for Physicians and Other Senior Health Workers
2005.
12
13
Laboratory
Complete blood count
14
Differential Diagnose
Appendicitis
Intussuception
Crohn disease
Irritable bowel syndrome
Treatment
ORS, iv infusion
Zn
Nutrition
Vitamin A
Antibiotic
Probiotic
WHO. The Treatment of Diarrhoea: a Manual for Physicians and Other Senior Health
Workers.2005.
15
16
17
Ionic composition of intravenous infusion solutions
Prevention
Water, sanitation, and hygiene:
Safe food:
18
19
CONSULTANT:
Irman Permana, Dr., Sp.A.
PRESENTED BY :
REIZKY MUHAR (109170023)
PEDIATRIC DEPARTEMENT
WALED GENERAL HOSPITAL
2015
CASE REPORT
Personal Identity
Name
: Sandi Nugraha
Age : 14 years old
Gender : Male
Religion : Islam
Fathers name : Wasjan
Education : Junior High School
Occupation : Mercant
Age : 40 years old
Mothers name : Ani Triani
Education : Junior High School
Occupation : Housewife
Age : 32 years old
CASE REPORT
Chief complaints: Diarrhea
History of present illness:
Patient came to the hospital with complaints of diarrhea since 1
day before hospital admission, the diarrhea continuously
perceived as much more than 4 times a day with a volume of
approximately 1 cup each defecate. A yellowish liquid stool, no
slimy, no bleeding, no stink, no pulpy. Patient also complain of
nausea and vomiting since one week before entering the
hospital. Currently hospitalized patients complain of shortness of
breath intermittent since two months ago, accompanied by chest
pain. Patients did not complain of fever, convulsions and chills.
Patients say that declining appetite.
PHYSICAL EXAMINATION
Generalized Status:
General state : Moderately ill
Sensorium : fully aware
Vital Sign
Blood Pressure : 110/70 mmHg
Respiration Rate : 24 tpm
Body Temperature : 36,1 oC
Antropometric Status
Body weight : 24,5 kg
Body height
: 135 cm
Nutrition Status
BMI/Age (Z-score) : 13,6/14 = -1 (Thin/Wasted)
Local Examination
Head
Local Examination
Thorax
Local Examination
Extremit
Neurology Examination
Consciousnes
RESUME
Patient came to the hospital with complaints of diarrhea since one day
before hospital admission, the diarrhea continuously perceived as
much more than 4 times a day with a volume of approximately one
cup each defecate. A yellowish liquid stool, no slimy, no bleeding, no
stink, no pulpy.
Patient also complain of nausea and vomiting since one week before
entering the hospital. Currently hospitalized patients complain of
shortness of breath intermittent since two months ago, accompanied
by chest pain. Patients did not complain of fever, convulsions and
chills. Patients say that declining appetite, but the symptoms doesnt
improve with this treatment.
These are the findings from physical examination. The general
appearance was moderately ill, the level of consciousness was
composmentis. BP: 110/70 mmHg, RR: 24 tpm, T: 36,1 BMI/A: -1
(wasted). From the local examination, sunken eyes and dry lips was
found.
DIFFERENTIAL DIAGNOSE
Gastroenteritis bacterial infection with mildmoderate dehydration.
Gastroenteritis viral infection with mildmoderate dehydration.
LABORATORY TESTING
Darah rutin
Haemoglobin
16,9
Basophil
Leucocyte
16,2
Eosinophil
Erythrocyte
6,4
Lymphocyte
26
Hematocrit
41
Monocyte
Segment
67
Stab
Platelet
529
MCH
26
MCHC
41
MCV
64
RDW CV
114
RDW SD
40,9
WORKING DIAGNOSE
Gastroenteritis bacterial infection with mildmoderate dehydration.
THERAPY
EDUCATION
Using a clean water
Cultivating the habit of washing hands with soap
after defecation and before eating.
Use a clean bathroom for the whole family
Improving the nutritional value of food in
sufficient quantity
PROGNOSIS
Prognosis :
- Quo ad Vitam
: Ad bonam
- Quo ad Functionam : Ad bonam
- Quo ad Sanationam : Ad bonam
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