PETA PASIEN BEDAH DIGESTIF

3 MARET 2014

MJI/BIP/MYH/WGF/EKP/NRM/DNA/FDL

BGSL

NAMA

USI
A

RM

MRS

6B

Ny kasinem

61

0121084
7

27/2

Susp intra abdomen

Pre op

6I

Ny. Sri rejeki

22

0103554
3

04/02

Post relaparotomi benton ai burst

abdomen

Post op

22/2

6E

Ny. Jumirah

60

0124341
8

23/02

Jaundice Obstruktif ec susp

malignancy

Pre op

7F

Ny B kasinem

78

0124322
1

21/2

Post op

2E

Ny supinah

74

0124414
5

28/2

LE dan reseksi anastomose

ileocaecal end to end ai ileus
obstruksiec perforasi ileum ec H
obstruksi inkaserata
Susp ca recty

3A

Tn. Hariyanto

39

0124318
0

24/02

Post haemoroidektomi ai haemoroid

interna gr III

Post
op

3D

Tn. Hartoyo

58

0124085
9

13/02

3E

tn paidi

50

0102349
5

1/3

Post laparotomi reseksi tumor +

transversocolectomi + PA ai tumor
colon transversum susp malignancy
T3N0Mo
Appendisitis kronis

4A

Ny. Sumi

73

0119988
4

25/02

4C

Ny sri kasyanti

48

0123403
4

24/2

4H

Ny. Sumirah

79

0107804
4

20/02

7E

Tn. Hardo Wiyono

78

0124222
5

18/02

7H

tn muslimin

40

0124270
0

20/2

8C

tn atmo

53

0122264
0

28/2

Adenocarcinoma recti

Pre op

Dr
IBM

8H

tn sutrisno

40

0124261
4

28/2

Obstruksi joundice ec tumor ampula

vateri

Pre op

1A

tn setu

56

0119877
2

26/2

Adeno ca recti

3A

Tn. Sri Warsito

54

0124297
3

19/02

Icterus obstruktif ec
choledococystitis

Pre op

3C

Ny. Kiyem

58

0123404
7

24/02

Pre op

4A

Tn. Wahyudi

48

0123061
3

20/02

7B

Ny lasmi

44

0124424
8

1/3

Adeno ca vesica felea post

laparotomy gastro jejunistomy,
cystostomy, jejuno jejunostomy
Adeno ca sigmoid diff buruk, post
laparotomi + sigmoidectomy
anastomose end to end
Ikterik obstruktivus ec batu cbd

10
A

Ny suparsih

73

0124401
8

27/2

Tumor intra abdomen susp metatase

r colli anemia azotemia

18
B

Ny. Sri Muwarni

47

0100173
0

17/02

Adeno ca collon

Mw1

Mw2

Mw3

Mlt1

Tgl
OP

KM

DIAGNOSA

Post laparotomi + reseksi

anastomose colon transversum ai
adeno ca colon transversum
Tumor intra abdomen DD tumor
colon transversum residif
anemia
Post laparatomy+reseksi tumor
sigmoid anastomose end to end
ileostomy ai pg ec perforsi colon
ascenden
Rectopexy dengan mesh per
laparotomy ai Prolaps recti
Post laparotomi + Graham Patch
procedure ai PG ec perforasi gaster
HM grade III
Laparatomy + ileosigmoidostomy S
to S ai tumor colon descenden

STS

SENIOR

Dr

PLAN

PJM

PEMERIKSAAN PENUNJANG

Perbaikan KU

BPJS

1/3 hb hb10,6 al 15 at 419

Dr.IB
M

Perawatan post op

BPJS

Dr

Tunggu hasil ERCP

dari TS Interna

BPJS

22/2

Dr
AR

Rawat luka

BPJS

05/02 Hb 10,7 AL 19,2 AT 472 Cr 0,5 Ur 25 Na 123 K 3,1 Cl

101
23/02 Hb 9,3 AL 15,4 AT 441
20/02 Hb 10,8 AL 9,6 AT 255 Cr 0,5 GDS 75 Alb 3,7 OT 65
PT 89 HbsAg (-)
22/02 BilDir 12,6 BilTot 18,4
USG Obstruktif ikterus (intra hepatal) kemungkinan karena
cholangiosarcoma
2/3 hb11,2 al10,6 at248
22/2 hb9,5 al 5,7 at 231

Dr IBB

Rectosigmoidoscopy +
biopsi

BPJS

28/2 hb 10,2 al 5,4 at 305

26/2

Dr.AR

Perawatan post op

BPJS

Post
op

20/2

Dr.AR

Perawatan luka

BPJS

22/02 OT 14 PT 15 Cr 0,9 Ur 73 Na 134 K 3,7 Cl 106 HbsAg

(-)
25/02 Hb 17,1 AL 7,8 AT 317 PT 11,9 APTT 30,4 GDS 73
14/02 Hb 10 AL 9,2 AT 369
20/02 Hb 11,7 AL 3,6 AT 287 GDS 184 Alb 3,1 Na 129 K 3,3
Cl 102

Post
op

3/3

Dr.AR

Appendiktomi

BPJS

19/2 hb15,7al 8,5at267 pt aptt 12.3 36,8 na k cl 136 4,2 109

Pre op

Dr.AR

Perbaikan KU
Pro tranfusi + CIL

BPJS

24/02 Hb 5,7 AL 14,3 AT 472 GDS 146 Cr 0,4 Ur 32 HbsAg

(-) CEA 55,07

Post
op

24/2

Dr IBB

Rawat luka

BPJS

28/2 hasil PA colon ascenden:adeno carsinoma differesiensi

buruk duke b2 hasil mikro esbl + S ampidansulbactam dan
ertapenem 25/2 hb11,5 al9,4at373 nakcl 133, 3,4 103

Post
op

25/2

Dr.AR

Perawatan post op

BPJS

Post
op

18/2

Dr.AR

Perawatan post op

BPJS

Post
op

24/2

Dr AR

Perawatan post op

BPJS

13/02 Hb 11,5 AL 10,5 AT 263 GDS 92 HbsAg

19/02 PT 12,4 APTT 28,9 GDS 90 OT 25 PT 20 Alb 4,2 Cr
0,4 Ur 15 Na 136 K 3 Cl 108
18/02 Hb 10,2 AL 9,0 AT 117 GDS 193 Alb 2,6 Na 145 K 3,4
Cl 116
21/02 Hb 10,0 AL 9,0 AT 153
28/2 hasil pa metastase adeno carcinoma27/2 alb 3,4 na k cl
135 4,5 cl 106 26/2 hb 9,9 al 19,8 at 481

Pro kemoterapi

BPJS

28/2 hb 10,7 al 18,2 at 82 gds 137

Dr IBB

Pro Ct san abdomen

kontras

BPJS

28/2 hb 9,7 al10,1 at 258

Dr AR

Pro kemo

BPJS

17/2 hb 15,1 al6,6 at 285 gds 114 cea 112,18

Dr.IBB

Evaluasi di ruangan

BPJS

Dr.IBB

Senin BLPL

BPJS

19/02 Hb 9,7 AL 6,7 AT 386 GDS 310 OT 64 PT 112

21/02 BilTot 26,60 BilDir 20,60 BilInd 6,00 Cr 1,1 Ur 28 Na
132 K 4,1 Cl 103
20/02OT 19 PT 19 Cr 1,0 Ur 66 Na 129 K 2,8 Cl 98
25/02 Hb 6,4 AL 6,6 AT 176

Dr.AR

Pro kemo

BPJS

19/02 Cr 1,0 Ur 34
22/02 Hb 10,1 AL 5,7 AT 175

Dr.IB
M

Pro mrcp dgn kontras

UMU
M

1/3 Alb 2,5 26/2 hb 14,1 al15 at 146 gds 109 biltot 13,7 bildir
10,8 otpt 69 81

Dr AR

Perbaikan ku ,transfusi
usg abd raber interna

BPJS

2/3 hb 6,7 al 9 at 144

Dr.IB
M

Perbaikan KU
Pro kemo

BPJS

17/02 Hb 13,1 AL 7,2 AT 378 GDS 165 Na 134 K 3,0 Cl 102

LAIN2

Interna

interna

RE
S