Kaka Renaldi
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Comparison of Endoscopic Ultrasound (EUS) and Magnetic Resonance Cholangiopancreatography (MRCP) in Diagnosing Cholelithiasis in Acute Biliary Pancreatitis Patients Nurleili, Rezky Aulia; Renaldi, Kaka; -, Resultanti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 3 (2015): VOLUME 16, NUMBER 3, December 2015
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (182.091 KB) | DOI: 10.24871/1632015197-202

Abstract

Aim: To determine how endoscopic ultrasound (EUS) is compared to magnetic resonance cholangiopancreatography (MRCP) in diagnosing cholelithiasis in acute biliary pancreatitis.Method: Five steps of evidence based medicine is conducted, they are: (1) Formulate the clinical question; (2) Search the evidence; (3) Appraise the study; (4) Apply the answer; (5) Assess the outcome. The search term in general is: (“cholelithiasis”) and (“EUS”) and (“MRCP”) and diagnosis.Results: We searched in Pubmed and Cochrane library. We excluded articles that do not focus on answering our clinical question. There is one systematic review that is capable of answering our clinical question.Conclusion: It can generally be concluded from this study that EUS and MRCP are useful techniques in the etiological diagnosis of acute pancreatitis of non-established cause. Endoscopic ultrasonography should be preferred for establishing a possible biliary etiology in patients who have not had a cholecystectomy.
Through-the-scope Polyethylene Balloon Dilations in Benign Corrosive Esophageal Stricture Complicated with Temporomandibular Joint Dislocation Arsita, Elli; Fauzi, Achmad; Gunawan, Jeffri; Renaldi, Kaka; Syam, Ari Fahrial; Abdullah, Murdani; Simadibrata, Marcellus; Makmun, Dadang; Manan, Chudahman; Rani, Abdul Aziz; Daldiyono, Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Esophageal dilation is a non-surgical management for anatomic and functional abnormalities causing both benign and malignant esophageal stricture. The basic goals of stricture dilation include safe and efficacious lumenal enlargement plus prevention of restenosis. These could be achieved using through- the-scope (TTS) balloon dilations, ranged in diameter of 4 to 40 mm, they will allow dilation of previously inaccessible strictures in the esophagus, stomach, small bowel, and colon. There are 5,000–15,000 cases of stricture due to ingestion of corrosive substances in United States every year. The following case would demonstrate a 28-year-old male with depressive disorder who attempted a suicide by ingesting corrosive substances two months before admission. Subsequently he started having difficulty in swallowing even soft foods. The complaint was gradually increasing until a month before admission he went through endoscopic examination and a corrosive esophageal stricture found. Hence after, he underwent dilation using Savary bouginage with fluoroscopy and through-the-scope (TTS) balloon dilations. The patient underwent a series of dilation treatment and demonstrated vigorous improvement. Problems raised as the patient was complicated with temporomandibular joint (TMJ) dislocation due to traumatic injury after ingesting corrosive substances. The consideration in management of esophageal stricture with complications will be discussed further in this article. Keywords: esophageal stricture, corrosive substances, dysphagia, temporomandibular joint dislocation, through-the-scope polyethylene balloon dilation
Influence of Fucoidan in Mucus Thickness of Gastric Mucosa in Patients with Chronic Gastritis Renaldi, Kaka; Simadibrata, Marcellus; Syam, Ari Fahrial; Rani, Abdul Aziz; Krisnuhoni, Ening
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: Chronic gastritis is commonly found with complains of dyspepsia, which may decrease work productivity. Imbalance between agressive and defensive factors is the cause of chronic gastritis. Therapy is mostly directed to the agressive factors, particularly gastric acid and very few studies are directed on defensive factors. Mucus is the first defense mechanism of gastric mucosa. Fucoidan is a phytopharmaca, which is thought to increase the thickness of gastric mucosa. The objective of this study was to know the thickness of gastric mucosa in patients with chronic gastritis and to evaluate the effect of fucoidan to the gastric mucosa thickness in patients with chronic gastritis. Method: In this double-blinded randomized clinical trial study, 41 patients in the Endoscopy Unit Cipto Mangunkusumo Hospital between October 2009 and October 2010 were enrolled consecutively. Selected patients were divided into 2 groups: a group was given fucoidan and another group was given placebo. Statistical analysis was done using T-test. Results: Of 41 chronic gastritis patients, only 34 patients completed this study. There was difference of mucus thickness of gastric mucosa in patients with chronic gastritis; in the antrum 42.59 µ m (± 8.67) and in the corpus 44.28 µ m (± 9.64). This study also showed that fucoidan administration increased the mucus thickness in the antrum by 7.42 µ m and in the corpus by 7.74 µ m compared to placebo significantly. Conclusion: Fucoidan increased the mucus thickness of gastric mucosa in patients with chronic gastritis. Keywords: mucus thickness, chronic gastritis, fucoidan
Through-the-scope Polyethylene Balloon Dilations in Benign Corrosive Esophageal Stricture Complicated with Temporomandibular Joint Dislocation Arsita, Elli; Fauzi, Achmad; Gunawan, Jeffri; Renaldi, Kaka; Syam, Ari Fahrial; Abdullah, Murdani; Simadibrata, Marcellus; Makmun, Dadang; Manan, Chudahman; Rani, Abdul Aziz; Daldiyono, Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/131201261-67

Abstract

Esophageal dilation is a non-surgical management for anatomic and functional abnormalities causing both benign and malignant esophageal stricture. The basic goals of stricture dilation include safe and efficacious lumenal enlargement plus prevention of restenosis. These could be achieved using through- the-scope (TTS) balloon dilations, ranged in diameter of 4 to 40 mm, they will allow dilation of previously inaccessible strictures in the esophagus, stomach, small bowel, and colon. There are 5,000–15,000 cases of stricture due to ingestion of corrosive substances in United States every year. The following case would demonstrate a 28-year-old male with depressive disorder who attempted a suicide by ingesting corrosive substances two months before admission. Subsequently he started having difficulty in swallowing even soft foods. The complaint was gradually increasing until a month before admission he went through endoscopic examination and a corrosive esophageal stricture found. Hence after, he underwent dilation using Savary bouginage with fluoroscopy and through-the-scope (TTS) balloon dilations. The patient underwent a series of dilation treatment and demonstrated vigorous improvement. Problems raised as the patient was complicated with temporomandibular joint (TMJ) dislocation due to traumatic injury after ingesting corrosive substances. The consideration in management of esophageal stricture with complications will be discussed further in this article. Keywords: esophageal stricture, corrosive substances, dysphagia, temporomandibular joint dislocation, through-the-scope polyethylene balloon dilation
Management of Gastric Motility Disorder Permana, Mustika Dian; Renaldi, Kaka
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 1 (2018): VOLUME 19, NUMBER 1, April 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (407.049 KB) | DOI: 10.24871/191201825-36

Abstract

Gastric motility disorder or gastroparesis is an objective slowing of gastrointestinal emptying syndrome, in the absence of mechanical obstruction, with cardinal symptoms such as rapid feeling of fullness, fullness sensation after eating, nausea, vomiting, bloating, and upper abdominal pain. Patients with gastroparesis are at risk of weight loss, malnutrition, and lack of vitamins and minerals, as well as increasing morbidity and mortality. The prevalence and incidence data of gastroparesis do not describe the true reality, because of the complexity of diagnosis. Beside Diabetes mellitus, many other causes should also be considered. Several studies have shown that nausea, vomiting and fullness sensation in abdominal are the most associated symptoms with gastroparesis. A 4-hour solid phase gastric emptying scintigraphy is the diagnostic standard for the slowing of gastric emptying. Lowest effective dose metoclopramide starting with a dose of 3 x 5 mg is the first line for pharmacological therapy. For persistent or refractory gastroparesis with pharmacologic therapy, gastric electrical stimulation (GES) and surgical therapy may be considered. The management should involve relevant medical team by not forget to consider patient comfort.
Diagnosis dan Tata Laksana Penyakit Celiac Oktadiana, Harini; Abdullah, Murdani; Renaldi, Kaka; Dyah, Nury
Jurnal Penyakit Dalam Indonesia Vol 4, No 3 (2017)
Publisher : Jurnal Penyakit Dalam Indonesia

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Abstract

Penyakit celiac merupakan penyakit enteropati proksimal terkait sistem imun yang bersifat reversibel, terjadi karena interaksi antara diet yang mengandung gluten dengan sistem imun di usus. Penyakit celiac memiliki manifestasi klinis yang beragam dan dapat terjadi pada usia berapapun. Jumlah penderita baru yang didiagnosis penyakit celiac meningkat karena meningkatnya kesadaran dan berkembangnya alat diagnosis yang lebih baik. Standar diagnosis penyakit celiac adalah berdasarkan uji serologi positif dan pemeriksaan histopatologi dari biopsi duodenum. Tata laksana penyakit celiac dengan diet bebas gluten akan memperbaiki gejala, kualitas kehidupan, mengurangi risiko keganasan dan komplikasi lainnya. Strategi pengobatan penyakit celiac dengan terapi non diet saat ini masih terus dikembangkan. Kata Kunci: diagnosis, penyakit celiac, tata laksana Diagnosis and Treatment of Celiac DiseaseCeliac disease is a reversible, proximal immune enteropathy resulting from the interaction of dietary gluten with the intestinal immune system. Celiac disease can produce varied manifestations and may develop at any age. New cases have increased substantially, due to increase awareness and better diagnostic tools. Standard diagnosis of celiac disease is based on positive serologic tests and histopathologic examination of duodenal biopsies. Treatment of celiac disease with free gluten diet will improve symptoms, quality of life, reduce risk of malignancy and complication. Nowadays, treatment strategy of celiac disease with non-dietary therapies is still underdevelopment. 
Pendekatan Diagnosis dan Tata Laksana Lesi Dieulafoy’s Saifuddin, Anshari; Renaldi, Kaka
Jurnal Penyakit Dalam Indonesia Vol 4, No 2 (2017)
Publisher : Jurnal Penyakit Dalam Indonesia

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Abstract

Lesi Dieulafoy’s merupakan salah satu penyebab perdarahan saluran cerna yang cukup jarang terjadi namun menjadi salah satu penyebab yang penting. Patogenesis penyakit ini berkembang dari awal penemuannya sampai sekarang. Dari studi terakhir dikatakan bahwa etiologi kelainan ini bermacam-macam, mulai dari genetik sampai pengaruh usia. Kelainan ukuran dan bentuk arteriol diketahui menjadi patogenesis utama kelainan ini. Endoskopi menjadi teknik diagnosis utama dengan efektivitas mencapai lebih dari 90%. Namun, pada beberapa keadaan kelainan ini sulit ditemukan melalui teknik endoskopi. Tata laksana utama adalah dengan teknik hemostasis via endoskopi. Teknik tersebut saat ini sudah berkembang dan bervariasi, mulai dari termal koagulasi, mekanik, sampai injeksi epinefrin. Seiring perkembangan teknologi kedokteran, prognosis penyakit ini saat ini cukup baik. Kata Kunci: diagnosis, lesi Dieulafoy’s, tata laksana  Diagnostic Approach and Treatment of Dieulafoys LesionDieulafoy’s lesion is a rare cause of upper gastrointestinal bleeding but become an important etiology. Pathogenesis of the disease evolved from earlier of its invention till now. It has been stated in recent study that the etiology of this disease is vary, from age to genetic. Size and arteriol configuration abnormality has been known as the main pathogenesis of the disease. Endoscopic procedure become the primary diagnostic tool, which effectiveness reached more than 90%. However, in some situation, it’s difficult to find the abnormality by endoscopic procedure. Hemostatic procedure via endoscopy is the main therapy of Dieulafoy’s lesion, which has been progressed from thermal coagulation, mechanical procedure, and epinephrine injection. The development of medical technology has made the better prognosis of the disease. 
Perdarahan Saluran Cerna sebagai Manifestasi Tuberkulosis Intestinum pada Pasien Lepra dengan Reaksi Reversal dan Riwayat Terapi Steroid Jangka Panjang Gebrina, Meutia; Nursyirwan, Saskia Aziza; Soewondo, Pradana; Fauzi, Achmad; Renaldi, Kaka
Jurnal Penyakit Dalam Indonesia Vol 3, No 1 (2016)
Publisher : Jurnal Penyakit Dalam Indonesia

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Abstract

Tuberkulosis usus merupakan suatu kondisi yang cukup sulit ditegakkan diagnosisnya. Gejala penyakit ini tidak khas dan pemeriksaan penunjang yang dilakukan seringkali menunjukkan hasil negatif. Salah satu gejala yang tidak khas dari tuberkulosis usus adalah perdarahan saluran cerna, yang harus menjadi kewaspadaan praktisi klinis.Kata kunci: perdarahan saluran cerna, tuberkulosis Gastrointestinal Bleeding as a Manifestation of Intestinal Tuberculosis in Leprosy Patients with Reversal Reaction and History of Long-Term Steroid TherapyIntestinal tuberculosis is difficult to be diagnosed. Signs and symptoms usually are not specific, and the results of diagnostictools are frequently negative. One of the unusual symptoms of intestinal tuberculosis is gastrointestinal bleeding, whichshould increase the awareness of clinical practitioners.Keywords: gastrointestinal bleeding, tuberculosis
Influence of Fucoidan in Mucus Thickness of Gastric Mucosa in Patients with Chronic Gastritis Renaldi, Kaka; Simadibrata, Marcellus; Syam, Ari Fahrial; Rani, Abdul Aziz; Krisnuhoni, Ening
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/122201179-84

Abstract

Background: Chronic gastritis is commonly found with complains of dyspepsia, which may decrease work productivity. Imbalance between agressive and defensive factors is the cause of chronic gastritis. Therapy is mostly directed to the agressive factors, particularly gastric acid and very few studies are directed on defensive factors. Mucus is the first defense mechanism of gastric mucosa. Fucoidan is a phytopharmaca, which is thought to increase the thickness of gastric mucosa. The objective of this study was to know the thickness of gastric mucosa in patients with chronic gastritis and to evaluate the effect of fucoidan to the gastric mucosa thickness in patients with chronic gastritis. Method: In this double-blinded randomized clinical trial study, 41 patients in the Endoscopy Unit Cipto Mangunkusumo Hospital between October 2009 and October 2010 were enrolled consecutively. Selected patients were divided into 2 groups: a group was given fucoidan and another group was given placebo. Statistical analysis was done using T-test. Results: Of 41 chronic gastritis patients, only 34 patients completed this study. There was difference of mucus thickness of gastric mucosa in patients with chronic gastritis; in the antrum 42.59 µ m (± 8.67) and in the corpus 44.28 µ m (± 9.64). This study also showed that fucoidan administration increased the mucus thickness in the antrum by 7.42 µ m and in the corpus by 7.74 µ m compared to placebo significantly. Conclusion: Fucoidan increased the mucus thickness of gastric mucosa in patients with chronic gastritis. Keywords: mucus thickness, chronic gastritis, fucoidan
Prevention and Management of Refeeding Syndrome Indrarespati, Andika; Renaldi, Kaka
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 3 (2016): VOLUME 17, NUMBER 3, December 2016
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (181.588 KB) | DOI: 10.24871/1732016200-203

Abstract

Refeeding Syndrome is a syndrome which occurs as a result of food administration in poorly nourished individuals. In this syndrome, there are wide range of biochemical alterations, clinical manifestations, and complications, starting from mild (asymptomatic) to severe (death). This syndrome was initially proposed in 1950s; however, there is still no agreement for its clear definition, causing clinicians to be less aware and tend to overlook this condition. Clinical manifestations which usually appear include electrolyte imbalances (hypophosphatemia, hypokalemia, hyponatremia, hypomagnesemia) and vitamin B1 deficiency. The main principle in management of refeeding syndrome is prevention, where clinicians need to identify this condition in the early stage in high risk individuals, supervision during refeeding, and administration of appropriate diet.