Hernia Umbilikalis Post Sectio Sesarea pada Kehamilan Ganda: Sebuah Laporan Kasus

Fenyta Christyani; Sigit Pradono Diptoadi

doi:10.24198/obgynia/v6n1.338

Hernia Umbilikalis Post Sectio Sesarea pada Kehamilan Ganda: Sebuah Laporan Kasus

Fenyta Christyani,^(1*) Sigit Pradono Diptoadi,⁽²⁾

(1) Rumah Sakit Atma Jaya Fakultas Kedokteran dan Ilmu Kesehatan Atma Jaya
(2) Departemen Obstetri Ginekologi, Fakultas Kedokteran dan Ilmu Kesehatan Universitas Katolik Indonesia Atmajaya, Jakarta, Indonesia
(*) Corresponding Author

Abstract

Tujuan: Mengetahui faktor risiko dan mekanisme terjadinya hernia umbilikalis pada pasien wanita post partum
Metode:Teknik pengumpulan data melalui wawancara, pemeriksaan, observasi, serta dokumentasi
Kasus: Perempuan G2P1A0 hamil 35-36 minggu, bekas sectio sesarea, janin ganda intrauterine dengan rencana sectio sesarea. Riwayat ANC rutin dan tidak ditemukan kelainan. Dua hari setelah operasi section sesarea pasien mengeluhkan mual, muntah, dan ditemukan massa pada regio umbilikalis dengan konsistensi keras, immobile, terdapat nyeri tekan dan suara bising usus. Luka operasi baik. Pada pemeriksaan USG abdomen tampak gambaran hernia ventralis paramedian kanan abdomen. Pasien kemudian dilakukan operasi laparotomi hernioraphy
Diskusi: Hernia umbilikal merupakan penonjolan usus yang berlokasi dekat umbilikus. Hal ini disebabkan oleh peningkatan tekanan intraabdominal dan kelemahan dari dinding perut. Terdapat beberapa faktor risiko yang mencetuskan. Faktor risiko pada kasus ini adalah obesitas, riwayat operasi sectio sesarea, dan kehamilan. Obesitas menyebabkan peningkatan tekanan intraabdominal, terjadi stress mekanik yang mengakibatkan gangguan dari metabolisme kolagen.
Kesimpulan: Pada wanita dengan kehamilan ganda, obesitas dan riwayat operasi sebelumnya menjadi faktor risiko terjadinya kejadian hernia umbilikal.

Umbilical Hernia Post Sectio Caesarea in Multiple Pregnancies: A Case Report

Abstract
Objective: To know the risk factors and mechanism of umbilical hernia in post partum female patients
Methods:Techniques through interviews, examinations, observations, and documentation
Case: G2P1A0 woman 35-36 weeks, former cesarean section with intrauterine multiple fetus with planned cesarean section. A history of routine ANC and no abnormalities were found. Two days after cesarean section the patient complained of nausea, vomiting, and found a mass in the umbilical region with a firm consistency, immobile, tenderness and bowel sounds. The surgical wound is good. On ultrasound examination of the abdomen showed a picture of the right paramedian ventral hernia of the abdomen. The patient then underwent laparotomy for hernioraphy
Discussion: Umbilical hernia is a protrusion of the intestine that is located near the umbilicus. It is caused by increased intraabdominal pressure and weakness of the abdominal wall. There are several risk factors that trigger it. The risk factors in this case were obesity, history of cesarean section, and pregnancy. Obesity causes an increase in intraabdominal pressure, mechanical stress occurs which results in disruption of collagen metabolism. Conclusion: In women with multiple pregnancies, obesity and a history of previous surgery are risk factors for the occurrence of umbilical hernia

Key words: Umbilical hernia, cesarean section, multiple pregnancies

Keywords

Hernia umbilikal, sectio sesarea, kehamilan ganda

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DOI: http://dx.doi.org/10.24198/obgynia/v6n1.338