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Pasien lupus mesenteric vasculitis dengan komplikasi perforasi ileum



Abstract

Lupus Eritematosus Sistemik (LES) merupakan suatu penyakit autoimun yang dapat mengakibatkan gangguan pada organ dan sistem organ. Kelainan gastrointestinal merupakan salah satu komplikasi yang memerlukan perhatian khusus pada pasien dengan LES. Lupus Mesenteric Vasculitis (LMV) merupakan salah satu komplikasi gastrointestinal dari LES yang menyebabkan keluhan nyeri perut pada pasien. Lupus Mesenteric Vasculitis (LMV) biasanya muncul dengan keluhan nyeri abdomen akut dengan onset mendadak, nyeri intensitas berat dan lokalisasi difus. Perforasi intestinal pada pasien LES merupakan suatu kondisi mengancam nyawa sehingga memerlukan pendekatan diagnosis dan tatalaksana yang tepat. Sebuah laporan kasus menunjukkan adanya LES dengan perforasi intestinal yang memerlukan tindakan pembedahan. Pasien datang dengan nyeri perut disertai kondisi syok sepsis. Pada pemeriksaan radiologis ditemukan adanya “air fluid level†dibawah diafragma kanan dan kiri. Selain itu juga ditemukan adanya dilatasi gaster, kolon dan sebagian dari usus halus disertai sentinel loop yang menunjukkan adanya inflamasi lokal. Pasien telah dilakukan tindakan laparotomi eksplorasi. Pasien kemudian dipulangkan setelah dirawat selama 7 hari di rumah sakit.

 

Systemic lupus erythematosus (SLE) is a systemic autoimmune inflammatory disease, which can affect almost all systems and organs.  Gastrointestinal disorder is one of the most noteworthy complications of patients with SLE. Lupus mesenteric vasculitis (LMV) is a unique clinical entity found in patients who present with gastrointestinal manifestations of systemic lupus erythematosus, and is the main cause of acute abdominal pain in these patients. LMV usually presents as acute abdominal pain with sudden onset, severe intensity and diffuse localization. Intestinal perforation in SLE patients is potentially life‑threatening so early diagnosis and prompt treatment are crucial to the management this complication of SLE. The present study reported a case of SLE with intestinal perforation, which required surgical intervention. Patient came with abdominal pain and septic shock condition. Radiological abdominal x-ray 3 position finding showed there is air fluid level in left and right below diaphragm. There is also dilatation on stomach, colon and half of intestinal with sentinel loop on below abdomen suggest local inflammation.  Patient have been done exploration laparotomy. Patient was successfully treated and discharged 7 days after hospitalization.

 

 

Keywords: Systemic lupus erythematosus Lupus mesenteric vasculitis acute abdominal pain peritonitis Intestinal perforation

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How to Cite

Nopriantha, M., & Kambayana, G. (2019). Pasien lupus mesenteric vasculitis dengan komplikasi perforasi ileum. Medicina, 50(2). https://doi.org/10.15562/medicina.v50i2.535
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