Osce Abdomen.pptx

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Cavum oris Orofaring Esofagus Lambung, Duodenum Jejunum, Ileum Colon

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Parotis Hepar Kandung Empedu Pankreas

- Abdominal X ray - Contrast studies - Barium meal - Small bowel study - Barium enema

- Ultrasound - CT - MRI

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Murah

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Cepat

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Mudah dilakukan

H. Ko 5

BNO

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Preperitoneal fat Psoasline Kontur kedua ginjal Distribusi udara Skeletal Soft tissue Konkremen opak

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Preperitoneal fatjaringan lemak yang tampak radiolusen pada abdomen bagian lateral dari atas-bawah di luar dinding kolon Makin ke bawah makin tebal Tebal normal 2-3 mm Normal ada setelah 5 bulan

H. Ko 8

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Psoasline bayangan agak opak yang dibentuk oleh m.psoas Normaljelas dan simetris Bayangan psoas menghilang: ◦ Tumor ◦ Hematoma ◦ Inflamasi/abses

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Besar ginjal + 2,5-3 korpus vertebra Posisi ginjal kiri lebih tinggi dari kanan sekitar ½ sampai1 korpus vertebra

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Ginjal kiri antara VTh12 sampai VL3 Aksis ginjal sejajar dengan aksis psoas line Di sekeliling ginjal tampak perirenal fat yang menyebabkan ginjal lebih jelas Permukaan ginjal normal rata

LT. KIDNEY

RT. KIDNEY

PSOAS MUSCLE

PSOAS MUSCLE

R

KUB

IVP INTRAVENOUS PYELOGRAM

(KIDNEY- URETERS- BLADDER)

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R

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Stomach

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Small bowel ◦ Jejunum ◦ Ileum

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Colon: ascenden, transversum,desenden

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Rectum

H. Ko 13

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Jejunum

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Ileum

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Colon

H. Ko 14

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Acute abdomen

H. Ko 16

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Perforation Intestinal obstruction Paralytic ileus Acute colitis Intraperitoneal fluid Inflammatory conditions Intramural gas Calcification associated with acute abdominal conditions

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Ng tube

ERECT

Multiple Dilated Loops of Small Bowel with Air/Fluid Levels Present at Different Heights

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Dilatasi small bowel Penebalan dinding Herring bone appearance (usus halus) Udara dalam rectum (-) Pada foto tegak tampak air fluid lever (step ladder appearance)

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Bayangan udara dalam colon lebih perifer berbentuk “inverted U” Dapat juga terjadi penimbunan cairan dalam cavum peritonei di darah pelvis

H. Ko 21

coffee bean

H. Ko 22

Small Bowel Obstruction

Ng tube

ERECT

Multiple Dilated Loops of Small Bowel with Air/Fluid Levels Present at Different Heights

UPRIGHT

POST – OP

COLON

ADYNAMIC ILEUS LARGE AND SMALL BOWEL SM. BOWEL

SYMMETRIC dilatation of large and small bowel is seen normally as a post operative ileus.

POST – OP ADYNAMIC ILEUS

Colon resection

NORMAL GAS PATTERN

AIR UNDER THE DIAPHRAGM

Perforation of GI tract leads to pneumoperitoneum collecting subdiaphragmaticly on upright x-ray

UPRIGHT

ERECT AND DECUBITUS ABDOMEN FILMS SHOW FREE AIR UNDER THE DIAPHRAGM. DECUBITUS

LEFT LATERAL DECUBITUS (left side dependent) shows air along liver margin. This is the preferred xray if the patient cannot stand.

Rigler’s Sign – See both sides of the bowel wall. Triangle Sign – Small triangles of air

Rigler’s Sign – Double Wall Sign

Cupula – Continuous Diaphragm Sign

TERIMA KASIH