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AUTHOR : Joko HerdiyantoNIM : I11109030LECTURE : DR. HILMI URNIA!AN RI"A!A# "$.A# M.e%DATE & DA' : rd 3 (e)r*ari +01, & -edne%day

NON D'"ENTRIORM ACUTE/A"TROENTERITI" A09 2 MILD

MODERATE DEH'DRATION E4,

Case Report

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Identitiy

A, boys, 1 years 10 month, was care inDahlia Room, no medic : 090434, KartikaHusada Hosital, !or " days, !rom date 3th

#01$ to %anuary &th #01$

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Chief Complain

De!ecate a watery stool

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'atient come de!ecate a watery stool within morethan 10()days, a yellowish color and sometimeblack, !eces resence o! mucus, dre*s ,not bloodand !e+er atient nausea and +omited # time,+omitin* o! !ood and water 'atient looks thirsty andstill want to drink water, but don-t want to eat,.rinate as usual normal De!ecation in atients alsono symtoms o! cou*h, colds, con+ulsions and losso! consciousness!ather atients were then *i+en aracetamol syrumedications, !e+er had decreased, but de!ecate the

atient-s condition does not imro+ed

1 day be!orehositali/ed

1 day be!orehositali/ed

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're+ious atient had suered !rom thesame comlaints and imro+ed without a

*i+en treatment or treated in a hosital ha+e no history o! sei/ure, aler*y , thyoid

!e+er, asthma

o !amily members with a similar

comlaints 'atient +aksin 2nly *et Bacille Calmette

Guerin ( 5 6 +accination

'atient 2nly *et 7 month o! A8 and ne(t

atient drink milk !ormula 'arents atient lowerclass economy

History o! *rowth and de+eloment isaroriate with any normal children

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56y%i7a8 Eaination

5eneral aearance : moderate sick, !ussy Awareness : omos mentis

Antroometry, ;58, #00&

;ei*ht : 10 k*

len*th : 73 cm wei*ht)a*e : 0 8D sd 1 8D

hei*ht) a*e : 0 8D sd 1 8D

;ei*ht)hei*ht : 1 8D

utrition state : normal

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 Vital Sign

Heart rate : 110 ()s, re*uler, stron* in alable Res Rate : 30()s, re*uler in rythm,

thoracoabdominal tye

 

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5eneralist 8tatus

Head : normocheal

=ye : on%un*ti+a anemic >)6, sclera icteric >)6,sunken eye >?)?6, tears >?)?6

=ar : secret >6,

ose : secret >6

@outh : wet lis and mucosa >?6, eck : enlar*ement o! lymh nodes >6

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•  un* : +esicular >?)?6, whee/in* >)6, rhonki >)6•  Heart : 81, 8#, re*uler, murmur >6, *allo >6• Abdomen

• nsection : domeshaed, mass >6• Auskultation : bowel sound >?6 increased• 'alasi : hear and lymh are not alable• 'erkusi : tymani in all Cled

• Anus 5enitalia : no abnormality• =(tremity : warm akral, Capillary Refll Time >R6

• 8kin : olour o! skin is brown, icteric >6, etechie >6, rash >6,tur*or returned slowly >?6

/enera8i%t "tat*%

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lood 3 %anuary #01$6

ormal

; 1#000 ) mm3 40001#000 )mm3

R ",0$ %uta 3,"0 G ","0 %uta

Hemo*lobin 1#,# *)dl 11,"14," *)dl

H< 344 3"""

'< 1$0000)mm3 1"0000400000

)mm3

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Dierential Dia*nose

on dysentri!orm Acute *astroenteritis ? mildmoderate dehydration

Dysentri!orm Acute *astroenteritis ? mildmoderate dehydration

holera ? mildmoderate dehydration

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;orkin* Dia*nose

on dysentri!orm acute *astroenteritis ?mildmoderate dehydration

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 tm6 micro• in%ection 'aracetamol 3 ( 100 m*• in%ection e!ota(ime 3("00 m*• n%eksi 2ndansetron 3 ( 1 m*• n%eksi Ranitidine # ( 10 m*• inc kid siru 1 ( 1 cth er oral• 'robiotik1(1 sachet er oral

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;&01&1, ?6,mucus>?6,blood >6, dre*s>?6,ause >6 Iomitin* water

and !ood >?6 3( time , !e+er >?6at ni*ht , drink >?6, eatdecreased >?6, .rinate>?6 *ood

De!ecate a watery stool #( >?6,dre*s >?6, mucus >6, blood >6, ause>6, Iomitin* >6, !e+er >6 , drink >?6,

.rinate>?6 *ood, eat usual

FOLLOW UP

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;&01&1,

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Discussion

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Problem of case

Dia*nose

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Discussion/a%troentiriti% ?6

Dia=no%e

In t6i% $atient: 

5astroentiritis ?

dehydration de!ecate watery stoolmore than N10 times,

  look !ussy- sunken eyes,

-

 thirsty,- wet lis and mucous, and-  tur*our returned slowly

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 Type of Diarrhea

Disentri!rom Diarrhea

 watery stool withmucus and blood, !e+er, tenesmus ani, ain inabdomen, rolasus ani

on Disentri!rom Diarrhea  Kids under #

years old, watery stool, hi*h !e+er, +omitin*,accomanied by cou*h and cold

holera  diarrhea that is watery andabundant, without receded by heartburn and

without tenesmus, abdominal crams Diarrheahas chan*ed >rice water stool6

n 'atient  watery stool with mucus, and notblood, +omitin*

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Stage Of Dehydration

Dehydration state can be determineob%ecti+ely by comare the body wei*htbe!ore and a!ter diarrhae 8ub%ecti+ely can beuse ;H2 criteria

n this atient, deCsit o! body wei*ht about$, and accordin* to the criteria o! ;H2 canbe classiCed as mildmoderate dehydration,

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 TREATMENT

Medi7ation *n7tion

IJD R $0 tm micro Rehydration

e!ota(ime 3("00 m*i+

 

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omlication

omlication o! diarrhea : Dehydration =lectrolit imbalance

Death

AdeOuate treatment can re+ent thecomlication

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Prognose

Recurrence rates deendin* on the le+el o!hy*iene o! atients where the arental role ino+erseein* and hy*iene o! !ood children are+ery inPuential At this child in +itamro*nosis and !un*sionam is ad bonam, whilesanationam ad malam

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 Thank You