Step 1

Flatus : keluarnya gas dari saluran anus

Distensi :proses peningkatan tekanan abdominal yg menghasilkan peningkatan
tekanan dlm perutdan menekan dinding perut dan menjadi pembesaran
(kembung)
Step 2
1.
2.
3.
4.
5.

Why the patient have off a bloating?

Why the patient has passed stole and flatus since two days ago?
Why is the patient vomiting containing food and has a greenish color?
What is mekanism of flatus?
What is the causes of a mass in the right inguinal region and extended to
his right scrotum with time (patogenesis)?
6. Why the mass appears when the patient is in standing position coughing
and straining and disappears when in the lying position?
7. What is the interpretation from the patient denies any hard, small, black
collored stole?
8. What is the relation between cronic cough with this case and not
undergone the abdominal surgery?
9. What is interpretation abdominal pain during palpation?
10.Why the anamnesis shows another symptoms including stomached and
decreasing urin output?
11.Why in the percution found hipertympany and metalic sound?
12.What is the diagnosis and DD?
13.What is the etiology in this case?
14.What is the risk factor of this case?
15.What is the treatment in this case?
16.What the complication in this case?
Step 3
1. Why the patient have off a bloating?
Kembung : lambung berisis makanan atau udara berlebih dan sekret
cairan berlebih. Kaitan obstuksi usus usus mengalami peregangan
absorbsi cairan menurun terjadi peningkatan ekskresi ke saluran cerna
hypertimpani
2. What is mekanism of flatus?
Udara berlebihudara tertampungintestinale spasmefermentasigas
productioninflated intestinaled
Udara masuk ketika makan, gas yg berdifusi dar drah ke dlm sal.cerna,
gas terbentuk dr hasil fermentasi bakteri
Gerakan peristaltik usustekanan tinggihukum tek.tinggi ke
rendahtek.rendah itu ada di anus
Sebelum ke anus gelembung kecil berkumpul menjadi gelembung besar
terus ke anus
3. Why the patient has pased stole and flatus since two days ago?
Gas tdk bisa keluar krn adanya obstruksi usus. Usus terjepit makanan
tdk bisa turun ke sal.cernaBAB tdk lancar. Konstipasi, neoplasma,
valvulus, invaginasi (ileum masuk saccum)
4. Why is the patient vomiting containing food and has a greenish color?

Obstruksidistensi usustek.intra lumen meningkatketumpuk tdk bisa

lanjutdikeluarkan/muntah
Obtruksi usus halusempedu keluar di duodenumobstruksi
ileusmuntah hijau krn tercampur cairan empedu
5. What is the causes of a mass in the right inguinal region and extended to
his right scrotum with time (patogenesis)?
Masa inguinal bag.kananherniamenjalar ke scrotumkuli angkat
berattek.tinggimenekanperitoniumileus keluarhernia
Kenapa ke kanan???
Tek intra abdomen meningkat gerak badan terlalu aktif batuk
menahun,BAB terlalu mengejanmendorong usus terdesak ke canalis bisa
jg ke scrotum
6. Why the mass appears when the patient is in standing position coughing
and straining and disappears when in the lying position?
Berdiritek.abdomen meningkatususnya terdorongtampak
Tidurantek.berkurangtdk nampak
7. What is the interpretation from the patient denies any hard, small, black
collored stole?
Otot perut tegangfeses kecilusus tdk relaksasi
zat besi berlebihbercampur darahbesi di oksidasikeluar hitam
usus besarhitam karena terlalu di usus besar
kecil hitamrectum bermasalah
darah ke hitam atau merah apa bedanya? Merah segar bawah, hitam atas
krn teroksidasi
hematemesis : muntah darah
melena: bab darah hitam
hemoptu : batuk darah
bab darah merah segar : hematokezia
8. What is the relation between cronic cough with this case and not
undergone the abdominal surgery?
Penjahitanadesi perlekatanperlekatan berlebihpenyempitan
ususobstruksi usus
Infeksipasien tdk minum antibiotikalat tdk bersih
9. What is interpretation abdominal pain during palpation?
Obstruksi ususmeransang sarafmerangsang
hipotalamuspenyempitan shg tdk bisa terdistensi dg baik
Hiperperistaltikgerkan makin kenceng utk mendorong obstruksiotot trs
bekerjagerakan mendorong lbh kuat makanya nyerilama2 otot pegel
10.Why the anamnesis shows another symptoms including stomached and
decreasing urin output?
11.Why in the percution found hipertympany and metalic sound?
12.What is the diagnosis and DD?
13.What is the etiology in this case?
Etiologibatuk, traumaherniaobtruksimakanan tertampung ususu
membesarperut membesarsusah bab dan flatus krn makanan tdk bisa
turun
14.What is the risk factor of this case?
15.What is the treatment in this case?
rehidrasi
16.What the complication in this case?

Peritonitis:membusuk di dalem
Dehidrasiekskresi dibuang ke saluran cerna semua
Anatomy, fisiology, hosto dr salran cerna bawah
Kenapa masih bisa dimasukan oleh jari, mengapa?