R/M/6 YO

It has been suffered since 3 days before admitted to Pirngadi Genral Hospital. For the first time he complained about epigastric pain which referred to Right Lower Quadrant for about 10 days ago. Nausea and vomitting was found, fever was found. He had been hospitalized for about 1 days in another hospital.

Status present Awareness : Alert BP : 110/70 mmHg HR : 82 x/i RR : 22x/i T : 37,6® C

Head:Eye : conjunctival anemis (-)

Neck: Normal  Thoraks : I : Symmetric Palpation? P : SonorA: Vesiculare, wheezing -/-, ronchi -/-

Abdomen: I : distention (-) P: tenderness (+), Muscular rigidity (+) Percussion? A : peristaltic (-) DRE :Perineum usual, TSA was loose,

Smooth mucosa, Pain in whole clockwise (+), ampula recti filled with stool, Gloves : Blood (-), mucous (-), stool (+)

Ekstremitas?

Hb / Hct / WBC / PLT: 12 / 34,9 / 14,180 / 272 PT / APTT / INR : 12,0 / 30 / 0,99 Na / K / Cl : 138 / 3,8 / 104 mmol/l Ur / Cr : 20 / 0,45 mg/dl SGOT / SGPT : 25 / 14 u/l Albumin : 3 g/dl Random Blood Sugar Level : 97 mg/dl

Diagnose : Diffuse Peritonitis d/t Appendicitis perforation

Treatment at the ER/ER Treatment : IV line with kristaloid 20 gtt/i NGT and cathether Patient was fasting Antibiotic Analgesic Patient was prepared for Laparotomy

Appendicectomy (perjelas ke bg darwin apa tindakannya)

THANK YOU!