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Defecation : Normal
Micturated : Normal
Physical Examination
General Conditions:
Moderate illness / well nourish / conscious
Vital sign:
BP : 120/70 mmHg
PR : 76 x/mnt, regular, adequate.
RR : 21 x/mnt.
T(Ax) : 37 C
PHYSICAL EXAMINATION
Abdomen
I : Seen convex, follow breath motion, no bowel contour, no bowel
motion, no tumor mass.
P : Tympani
Rectal Toucher
Ureum : 43 mg/dl
MANAGEMENT : IVFD
Apply NGT
Apply Foley Catheter urine
Medicaments
Report to Senior Digestive Surgeon
advice : Immediate Laparotomy
OPERATION PROCEDURE
Patient laid supine under GA
Disinfection and drapping procedure
Performed midline deepen layer by layer, until
peritoneum
Identify, seen dilatation on every part of the bowel
Seen volvulus ileum and multiple band, 50cm on distal
part and 90 cm proximal part from the ileocaecal valve
Seen ischemic part of the ileum, resection of the ileum is
performed
Decompression of the of the dilatated ileum
Perform end-to-end anostomosis
Control the bleeding and rinse cavum abdomen
Close wound layer by layer with 1 drain
Done
POST OP DIAGNOSIS : Intestinal obstruction e.c volvulus
multiple band
SIRS
PROGNOSIS : Good