LOPERAMIDE AND CODEINE THERAPY FOR ENTEROCUTANEOUS FISTULA : CASE SERIES
DOI:
https://doi.org/10.31004/prepotif.v8i3.36277Keywords:
Codeine, Enterocutaneous Fistula, LoperamideAbstract
Fistula enterokutan (Enterocutaneous Fistula/ECF) adalah hubungan abnormal antara saluran pencernaan intra-abdomen dan kulit atau luka. Keberadaan saluran ini menyebabkan cairan lambung atau usus bocor ke lingkungan eksternal. ECF dapat disebabkan oleh berbagai faktor, namun paling sering terjadi sebagai komplikasi pascaoperasi. Dalam seri kasus ini, disajikan dua kasus ECF yang ditangani menggunakan kombinasi loperamide dan codeine. Laporan Kasus 1: Seorang wanita berusia 46 tahun dengan obstruksi ileus total akibat Adenokarsinoma kolon transversum (grade rendah) cT4N1M1 (metastasis hati) menjalani laparotomi, adhesiolisis, dan hemikolektomi kanan ekstensif. Pemeriksaan pascaoperasi menunjukkan ECF dengan keluaran tinggi dan kebocoran anastomosis. Pasien distabilkan melalui koreksi elektrolit, nutrisi, antibiotik, serta terapi konservatif menggunakan loperamide, codeine, omeprazole, dan octreotide. Perawatan luka menggunakan vacuum-assisted closure (VAC). Laporan Kasus 2: Seorang wanita berusia 39 tahun dengan kanker ovarium stadium lanjut rekuren menjalani laparotomi dengan debulking. Luka pascaoperasi mengalami dehiscence yang berkembang menjadi ECF dengan keluaran rendah. Pasien dirawat dengan nutrisi, antibiotik, loperamide, codeine, dan omeprazole. Kantong kolostomi digunakan untuk perawatan luka. ECF merupakan kondisi kompleks yang sering kali berasal dari komplikasi bedah dan sulit diatasi. Seri kasus ini membahas terapi konservatif dengan loperamide dan codeine.References
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