MAPPING DIGESTIF (Senin, 19 OKTOBER 2018)

Kamar Identitas HR Diagnosis Lab DPJP Planning

Raudah 3
K3B2 Zakirah AD 8 Choledocolithiasis post *lab 13/11/2018* dr. M.Yusuf,
laparotomy + explore hb/ht/E/ L/ Tr : Sp,BKBD*
bangkit, pr,
CBD 11,3/34/4,3/6,3/419
50 thn, ur/cr : 22/0,62
1179u46 na/k/cl : 147/3,4/107
Albumin : 3,68
GDS : 121
Bil T/D/I : 1,37/0,88/0,49
SGOT/SGPT :60/3,68

K4B1 Ratnawati POD Status ileostomy + Lab 15/11/2018 dr. M.Yusuf,

adhesi internal post Protein total : 5,39 Sp,BKBD*
M. Ali, pr, 8
ileostomy closure + Albumin : 2,88
41 thn, adhesiolisis Globulin : 2,51
1158026
*Lab 13/11/2018*
Hb/ht/E/L/T:
11,6/33/4,0/16,6/325
Ur/Cr: 16/o,57
Na/K/Cl: 3,8/144/104
Protein total/ a
lbumin/globulin :23atau 44

SGOT/SGPT : 61/78

K4B3 Siti AD 5 Tumor intra abdomen Lab 17/11/2018 *dr. M.Yusuf,

(rhabdomio sarcoma) Hb/Ht/E/L/T : Sp,BKBD*
Fatimah,
10,5/28/4,0/8,1/323
pr, 39 thn, Na/K/Cl : 118/6,0/82
1158026 protein total : 6,38
Albumin : 3,44
Globulin : 2,94
Ca : 8,0
Kgds : 88
Lab 14/11/2018*
Hb/ Ht/ E/ L/ Tr :
8,6/25/3,5/10,6/427
Ur/Cr: 82/2,41
Bil T/D/I : 2,31/1,72/0,59
SGOT/SGPT: 279/262

K5B1 Rukiah AD Tumor intra abdomen Lab 14/11/2018 dr. Ferry E,

Protein total : 4,86 Sp.BKBD
Abdul 16
Albumin : 2,72
Gani, pr, Globulin : 2,14
50 thn, Ca : 10,4
1066349 Na/K/Cl : 141/2,6/94
*lab 12/11/2018*
na/k/cl : 143/3,1/102
Ca : 10,9

*lab 11/11/2018*
hb/ht/E/ L/ Tr :
10,5/29/3,7/16,5/177
ur/cr : 115/1,04
na/k/cl : 138/2,3/96
Ca : 10,5

*Lab 10/11/2018*
albumin: 2.99

*Lab 7/11/2018*
alb / globu/ protein total :
2.58/ 3.33/ 5.91
K6B1 Erlina POD hernia diafragmatika S Lab 14/11/2018 dr. M.Yusuf,
post repair hernia Hb/L/E/T/L : Sp.BKBD
Zainuddin, 5
10,6//31/3,9/592/11,3
pr, 53 thn, Na/K/Cl: 132/3,6/88
1190119 ur/cr : 8/0.36
 Protein
total/albumin/globulin :
5,8/2,90/2,91

Lab 15/11/2018:
Ns/K/Cl/Ca: 137/3,8/97/7,4

Lab 14/11/2018*
Hb/L/E/T/L :
12//34/4,4/319/26,8
Na/K/Cl: 135/3,2/97
ur/cr : 14/0.36
SGOT/SGPT : 43/28
Protein
total/albumin/globulin :
4,82/2,66/1,94
K7B1 Hamidar Obs joundice ec Lab 17/11/2018 Dr. Ferry E
choledocolithiasis + Hb/Ht/E/L/Tr: SpBKBD
Koto, Pr,
Cholesistitis 8,1/24/4,1/7,3/326
64 th Bil total: 1,86
1190634 Bil direct: 1,06
Bil indirect: 0.8
Ur/Cr: 9/0,54
Na/K/Cl: 147/4/108
GDS: 126
K7B2 Jasmawati, Obs Joundice ec *dr. Muslim,
cholelithiosis + Sp,BKBD*
Pr, 41th
Cholesistitis
1187359
K7B4 Fitriani Akalasia Lab 1/11/2018 *dr. M.Yusuf,
Hb/Ht/E/l/Tr Sp,BKBD*
Cut Ben,
13,6/39/4,5/8.3/285
Pr 36 th Albumin: 4.37
1134400 GDS: 83
U/Cr: 26/0.97
Ns/K/Cl: 146/4,6/108
K7B3 Maryam AD2 Obs jaundice ec Sup Lab 19/11/2018* *dr. M.Yusuf,
Tumor CBD Hb/HT/E/L/T : Sp,BKBD*
Abdullah
11,3/28/3,5/15,7/329
Pr 57 th Albumin: 2,65
1191487 Globulin: 2,55
Prot total: 5,20
K7B5 Nilawati AD 5 Tumor recti 1/3 distal + Lab 18/11/2018: Dr. Ferry E
Fistel rectovaginal Na/K/Cl/Cs: 137/3,2/99/8,1 SpBKBD
Abdullah,
38 th Lab 16/11/2018*
Hb/HT/E/L/T :
11/32/4,2/18,2/479
Na/K/Cl : 138//3,0/101
Ur/Cr: 14/0.92
Albumin: 3,18
Globulin: 3,01
Prot total: 6,19
K7B6 Hajjah M. AD2 dr. Ferry
Erdani,
Salleh
Sp.B(K)-BD
Pr 44 th
0977191

RAUDAH 5
K1B1 T. AD2 Hemoroif gr II + HIL lab 18/11/18 dr. M.Yusuf,
(D) Hb/ht/e/l/t: Sp,BKBD*
Rasyidin
17,5/49/8,3/36,9/441
lk, 55 th Ur/cr: 59/2,38
1191471 Na/k/cl: 145/5,0/100
K3B2 Aiyub bin AD 6 Susp. TB peritoneal + lab 14/11/18* dr. Ferry
massa Hb/ht/e/l/t: Erdani,
Mahmud ,
13,7/40/5,6/9,6/465 Sp.B(K)-BD
lk, 56 th, Ur/cr: 26/0,72
119116* Na/k/cl: 143/3,8/100
Albumin: 3,72
Globulin: 1,85
Prot total: 4,62
K4B3 Abdul AD 5 Striktur esofagus 1/3 *lab 16/11/18* dr. Ferry
proksimal Hb/ht/e/l/t: Erdani,
Jalil,lk,48
10,8/32/4,8/10,0/512 Sp.B(K)-BD
th Ur/cr: 20/0,54
,1191263 Na/k/cl: 144/4,6/94

*lab 14/11/18*
Hb/ht/e/l/t:
10,8/32/4,8/10/512
Ur/cr: 20,0,54
Na/k/cl: 144/4,6/94

K5B2 Daud Abdominal pain ec LE *lab 15/11/18* dr. Ferry

CBD + T tube Hb/ht/e/l/t: Erdani,
Ginting, 66
13,7/41/4,5/10,6/225 Sp.B(K)-BD
th Ur/cr: 17/0,80
Na/k/cl: 145/3,9/98

K5B3 Aqil Salim AD 3 HIL (D) Ressible lab 16/11/18 dr. M.Yusuf,
Hb/ht/e/l/t: Sp,BKBD
lk, 27 th
17,1/46/5,5/8,8/289
1058797 Ur/cr: 18/0,28
Alb; 4,92
Gds ; 94
Na/k/cl: 142/3/7/96

K6B1 Zakaria POD Necrotic stoma + adhesi dr. Ferry

post relaparatomy + lab 16/11/18 Erdani,
Jafar, lk, 8
recolostomy Hb/ht/e/l/t: Sp.B(K)-BD
54 th, 8,4/23/3,1/12,2/277
1189598* Ur/cr: 22/0,58
Na/k/cl: 142/3/7/96

*lab 13/11/18*
Ca : 6,0
Na/k/cl : 147/3,3/113

*lab 12/11/18*
Ca : 7,7
Na/k/cl : 148/3,9/106

*lab 10/11/18*
Hb/ht/e/l/t:
13,1/36/4,9/42,4/732
Sgot/sgpt: 48/50
Ca: 7,8
Ur/cr: 25/0,62
Na/k/cl: 143/3,8/100

*lab 9/11/18*
Albumin: 2,77
Globulin: 1,85
Prot total: 4,62
K6B5 Razali, Lk, POD Post laparotomy + Lab 17/11/2018 dr. M. Yusuf,
omentectomy + Na/K/Cl/Ca: 141/4,9/100/8,1 Sp.B-KBD
53 Thn, 4
splenectomy+ distal
1190493 pancreatectomy ec Lab 16/11/2018
tumor lien infiltrasi Hb/Ht/E/L/Tr:
pancreas + omentum 9,9/27/3,5/23,1/454
podt LB + acute Na/K/Cl/Ca:139/3,6/99/8,3
respiratory failure +
HHD Lab 13/11/2018*
Hb/HT/E/L/T :
11,6/33/4,5/415/20,7
Na/K/Cl : 139/3,8/98
Ur/Cr : 9/0,55

Lab 8/11/2018*
SGOT/PT: 21/12
GDS : 87
HbsAg : negatif
alb : 2,44
Globulin : 4,16
CT/BT : 7/2
K6B4 Zainal High Output Lab 12/11/2018* dr.M.Yusuf,A
Enterocutan Fistula Post Hb/HT/E/L/T : p.B-KBD
Ismail, Lk,
Perforasi Hernioraphy + 12,23/34/4,3/13,9/531
55 Thn, Laparotomy
1188528
Lab 7/11/2018*
Hb/HT/E/L/T :
9.7/27/3,4/12,3/607
Na/K/Cl : 137/3,7/85
Ur/Cr : 63/0,48
Albumin/globulin : 3,01/3,37
GDS : 70
Bilirubin Total : 0,52
B. Indirect : 0,3
B. Sirect : 0,22

K6B6 Fakhrizal POD Obstruksi Joundice e.c Lab1 7/11/2018* dr. M. Yusuf,
Choledocolithiasis + Hb/HT/E/L/T : Sp.B-KBD
Yusri, Lk, 3
Post laparotomy 10.2/29/4.3/11,1/169
28 Thn, cholesistectomy + Albumin: 3,2
1184044 adhesiolisis + biopsi Ur/Cr: 30/0,71
Na/K/Cl: 134/6,4/89

*Lab 14/11/2018*
Kolestrol
Total/HDL/LDL/trigliserida
: 191/27/117/212

HbA1c : 6,00

*Lab 13/11/2018*
Hb/HT/E/L/T :
10,9/31/4,5/5,6/186
Na/K/Cl : 139/4,9/103
Ur/Cr : 33/0,80
Albumin: 3,26

*Lab 7/11/2018*
Hb/HT/E/L/T : 8,5/24
/3.8/4,7/128
Na/K/Cl : 136/3,4/99
Ur/Cr : 17/0,43
CT/BT : 8/3
SGOT/PT: 44/117
GDS : 221
Bil dirk/indirek: 18,02/4,97
Bil total: 22,99

K7B1 Zulfikar AD2 Periapendikular Infiltrat Lab 18/11/2018* dr. M. Yusuf,

Hb/HT/E/L/T : Sp.B-KBD
Ridwan lk,
9,9/29/4,1/6,5/642
26 th Na/K/Cl : 134/4,0/100
1191769 Ur/Cr : 20/0,48
CT/BT : 2/7
SGOT/PT: 24/18
GDS : 102
Alb; 2,37
K7B5 Jumali Obstruksi jaundiece ec : Lab 18/11/18* dr. M. Yusuf,
1. Choledocolitiasis Hb/Ht/E/L/T: Sp.B-KBD
Maeran,
2. tumor intrabdomen 9,2/25/3,2/19,5/73
Lk, 54 Thn, Ur/Cr: 22/0,58
1190612 Na/K/Cl: 134/3,0/104
Albumin/globulim/protein
total:2,59/2,18/4,77

Lab 15/11/18*
Hb/Ht/E/L/T:
9,4/26/3,3/24,7/108
Ur/Cr: 20/0,91
Na/K/Cl: 152/4,4/96
 Albumin/globulim/protein
total:2,4/2,07/4,47

Lab 13/11/18*
Hb/Ht/E/L/T:
10,2/29/3,6/14,0/227
Ur/Cr: 13/0,56
Na/K/Cl: 137/3,3/102
Albumin : 2,01
CA 19-9 : 500,00

Lab 10/11/2018*
Hb/Ht/E/L/T :
9,9/27/3,5/19,4/187
CT/BT : 8/3
HbsAg : Negatif
Bil total : 20,7
Bil direct/indirect : 15,7/5
SGOT/SGPT : 113/101
GDS : 178
ur/Cr : 20/0,55
Na/K/Cl: 131/2,9/90
K7B6 Juliadi Status colostomy Lab 21/9/2018: dr. M. Yusuf,
Hb/Ht/E/L/Tr: Sp.B-KBD
Emran, Lk,
15.3/45/5.4/7.6/287
31 th Albumin: 4.33
1174284 Ur/Cr: 14/4.33
Na/K/Cl: 147/4/109
ISO 1 Amiruddin Ulkus os sacrum + ca Lab 15/11/2018* dr. M. Yusuf,
recti 1/3 proksimal post Hb/HT/E/L/T : Sp.B-KBD
M yusuf ,
kemoterpi + anemia 11,0/32/4,2/19,2/376
60 Thn, Na/K/Cl : 131/4,5/100
1108518 Ur/Cr : 24/0,71
Albumin/globulin : 6,67/2,67
SGOT/SGPT: 16/12

Lab 12/11/18*
Hb/Ht/E/L/T:
5,9/18/2,4/22,9/616
GDS: 160
Ur/Cr: 28/0,87
Na/K/Cl: 133/5,0/98

Zam-Zam 3
K3 Marlaini AD 2 Cholelithiasis Lab : 6/11/2018 dr. Ferry
Hb/Ht/E/L/T: Erdani,
Abu Bakar,
13,8/40/4,8/14,7/399 Sp.B(K)-BD
Pr, 44thn, Ur/Cr : 20/0,59
1185099 Na/K/Cl: 146/4,5/110
Bil.total/bil.direct/bil.indirect
: 0,40/0,12/0,28
SGOT/SGPT: 16/4,26
Albumin : 4,26

K6 Prof. Said Hernia inguinal lateralis Lab 15/11/18 *dr. Muslim,

reposible Hb/Ht/E/Tr/L Sp,BKBD*
Muhamma
12.6/4/5.6/235/7.8
d, Lk, GDS: 113
1046943 Ur/Cr: 29/1.15
Na/K/Cl: 146/4.5/107

Zam-Zam 4
K12 Suhaimi C. AD1 Obstruksi jaundice ec Lab : 13/11/2018 dr. Ferry
cholelitiasis multiple + Hb/Ht/E/L/T: Erdani,
Pr 67 th
Anemia 7,6/20/2,6/13,4/100 Sp.B(K)-BD
1190367
K 16 Nurdjanah, AD 2 Obs.jaundice ec. Susp. Lab : 15/11/2018 dr. M. Yusuf
Choledocolithiasis dd/ Hb/Ht/E/L/T: SpBKBD
pr, 69thn,
susp tumor distal CBD 11,1/29/3,8/7,5/304
0857974 Susp striktur CBD Ur/Cr : 17/0,59
Na/K/Cl: 140/3,0/98
 Bil.total/bil.direct/bil.indirect
: 20,13/15,10/5,03
SGOT/SGPT: 771/694
Albumin : 3,33

HCU Surgical
Bed 9 Burhanudd POD Total MBO ec tumor Lab 17/11/18 dr. M. Yusuf
caecum post LE + Hb/Ht/E/Tr/L SpBKBD
in abd, 46 12
reseksi ileo colon 7.7/22/2.8/45/35.5
thn, ascenden + PT/Kontrol: 25.5/10.9
1173546 ileotransverostomy INR: 2.55
double barrel + biopsi APTT/Kontrol: 72.5/34.1
D-dimer: 4191.07
Albumin: 2.13
Ur/Cr: 118/2.44
Na/K/Cl/Ca: 124/5/88/5.8

*lab 12/11/18*
Hb/Ht/E/L/Tr :
10,9/29/4,5/20,4/23
Na/K/Cl : 136/4,2/103
Ca: 7,7

*Lab 11/11/18*
Na/K/Cl : 136/3,8/104
Ca: 8,1

*lab 7/11/18*
Hb/Ht/E/L/Tr :
13,4/38/5,5/20,3/99
Na/K/Cl : 139/3,2/103
Ca: 8,3

Bed 2 Rukiyah M POD Leakage anastomosis Lab 18/11/18 dr. Ferry E,

colorectal + multiple Hb/Ht/E/Tr/L: Sp.BKBD
Amin, pr, 11
poket abses + adhesi 11/31/4.5/344/6.7
63 thn, intestinal post PT/kontrol: 10.8/10.9
1178969 laporotomi explorasi + INR: 1
colostomi + adhesiolisis APTT/kontrol: 35.6/34.9
+ debridement intra D-dimer: 1205.04
abdomen SGOT/SGPT: 15/11
Albumin: 2.23
Na/K/Cl/Ca
146/2/101/7
Ur/Cr:19/042

lab 6/11/2018*
alb : 3.30
ur/cr : 14/ 0.66
na/k/cl : 144/ 3.0/ 120

*lab 2/11/2018*
hb/L/Tr: 13.9/ 7.8/ 334
alb : 2.79
sgot/ sgpt : 17/8
ur/cr : 21/ 0.75
na/k/cl : 143/ 3.8/ 110

Ramli POD Penetraiting injury with Lab 17/11/18:

stable hemodinamik + Hb/ht/E/Tr/L
Muhamma 3
Internal bleeding + 12.3/36/4/163/12.3
d, Lk, 54 ruptur splen + blood PT/Kontrol: 10.6/10.9
Bed 8 th cloth INR: 0.98
1031938 APTT/kontrol: 34.5/34.1
D-dimer: 467.35
Albumin: 3.6
Na/K/Cl/Ca: 145/4.5/103/8.1
Ur/Cr: 23/1.3

Bed 11 Mawardi POD Blund Thoracobdominal Lab 18/11/18: dr. M. Yusuf

injury + tensiom Hb/ht/E/Tr/L SpBKBD
M Minto 1
pneumothoraks 10.7/29/3,5/277/27,3
lk, 18 th Na/K/Cl/Ca: 140/4.4/101
1191461 Ur/Cr: 23/12.3
Nabawi
K1B4 Ruhaida AD1 Lab 18/11/18: dr. Ferry
Hb/ht/E/Tr/L Erdani,
Abubakar
10.6/32/4,3/463/14,8 Sp.B(K)-BD
pr, 38 th Na/K/Cl/Ca: 140/2.8/81
1187794 Ur/Cr: 25/0,38

ICU D
Bed 2 Abdul POD General partial Lab 18/11/18: dr. M. Yusuf
peritonitis ec leage Na/K/Cl/Ca: 141/6.3/99/7.1 SpBKBD
Munir, Lk, 2
anastomosis ileo ileal ec Ur/Cr: 59/2.15
56 th total MBO post +
1191357 hemoprapul dgn most Lab 17/11/18:
graft bilateral post LE + Hb/Ht/E/Tr/L:
adhesi intestinum 13.6/36/4.9/502/18.5
PT/Kontrol: 11.5/10,9
INR: 1,01
APTT/Kontrol: 35,9/34,9
D-Dimer: 6233,52
Albumin: 2.63
Na/K/Cl/Ca: 139/4.3/99
Ur/Cr: 33/0.6
Bed 6 Abu AD II Partial MBO ec aki stage Lab 18/11/18: dr. M. Yusuf
III + Hipoalbumin + Hb/Ht/E/Tr/L: SpBKBD
Bakar,lk,83
imbalance elektrolit + 11.7/34/3.8/185/6.8
thn peritonismus + PSMBA Na/K/Cl/Ca: 146/5.1/119/6.9
ec ulkus gaster, ulkus
duodenum, gastritis Lab 17/11/2018*
erosif PT/APTT : 13/54,4
Bil.total/b.direct : 0,95/0,53

Lab 16/11/2018*
Hb/HT/E/L/T :
12,1/35/3,9/7,6/237
Na/K/Cl : 142/5,2/112
Ur/Cr : 153/3,89
SGOT/SGPT : 28/12
Albumin : 2,61
HBsAg : -

AQSA 2
K2B2 M Yasin. lk AD5 Hyrops gallbladder + Lab 16/11/2018* dr. M. Yusuf
cholelitiasis + Hb/HT/E/L/T : SpBKBD
59 th
Hipoalbiumin + Anemia 8,1/22/2,8/19,3/244
0920106 Na/K/Cl : 150/3,2/114
Ur/Cr : 55/1,56
Albumin : 2,55
Ca ; 7,7
AQSA 3
K3B1 Eliva M. AD1 Cholelitiasis Multipel Lab 16/11/2018* dr. Ferry E,
Hb/HT/E/L/T : Sp.BKBD
Husni, pr,
9,3/27/3,6/6,1/294
36 th Na/K/Cl : 142/4,2/100
1184632 Ur/Cr : 15/0,88
Gds ; 58