A. THEORY
Etiology
The cause of the cyst coledocal still debated. One explanation can be accepted and explained by Babbit. He suggested a linkage between the biliary duct pakreatikus abnormally with the establishment of a "channel" where the secretion of pancreatic enzymes released into the biliary duct wall caused by the vandalism of fragile enzyme that causes gradual dilation, inflammation and eventually formed cysts. But keep in mind that not all cases of cyst formation coledocal show "channel".
Coledocal cyst is more prevalent in women than in men (4: 1). Symptoms commonly called compleks classic symptoms described in the clinical manifestations.
Pathophysiology
There are various explanations and coledocal cyst classification based on the location and anatomy. Classification of the help made by Todani modified from the classification developed by Alonsolej. The first type is characterized by the merger (fusiform) dilated biliary duct where duct cyst in (most common). Coledocal cyst is considered an initial overview of the biliary system disorders pankretikus. Some of the circumstances that are often associated with cysts coledocal is a state jungta pancreatic duct anomalies and large biliary duct, stenosis of the distal biliary duct, intra-hepatic duct dilatation. Histological abnormalities and abnormalities of the biliary ductal histology of normal liver to liver cirrhosis. These figures take place in several stages and the combination of changes in anatomy and malformations.
Clinical Manifestations
The nurse is important to know the clinical manifestations of cystic coledocal, where information obtained during the assessment.
Common signs of cyst called clssic sympton coledocal copleks include pain, a mass, yellow experienced less than half the patients. Signs are more often seen is abdominal pain that often recur after several months or years. Usually only a few shows jaundice. If the condition persists, it can happen colangitis, serosis and portal hypertension.
DIAGNOSTIC TEST
Coledocal cysts in infants or fetuses can be detected by maternal antenatal ultrasound. In adults performed ultrasonography and computerized axial tomography. Endoscopic retrogrde echolangiospancreatography (ERCP) performed in patients when the results are less clear noninfasiv procedures.
Nursing Diagnosis
According to Spark, nursing diagnoses are common in patients with cystic coledocal are:
1. Painful
2. Impaired self kosep
3. Changes in nutrition
4. Impaired gas exchange
Intervention
1. Medical Intervention
Surgery include internal drainage through systerectomy and excision. Morbidity of the action is quite high. Cyst wall consists of connective tissue covered with mucous membrane. Unexpected events is scar tissue obstruction. Furthermore, tissue cysts can not be contracted after drainage.
Morbidity can also disebabka by biliary stasis. Another risk is the growth of malignant due to retention cysts. For this it is recommended cyst resection.
Successful resection require action by inserting a circular dissection plane between the cyst and the portal vein to facilitate removal. In this procedure possible injury to the pancreatic duct. Another alternative procedure can be performed when anatomically porta driven by inflammation.
2. Nursing interventions
Nursing interventions conducted in order to overcome the problem that is described in kperawatan diagnosis and directed to prevent injury. In general, nursing actions include:
§ Reduce pain
§ Assist the patient to recover his self-concept, face and accept reality and to develop problem-solving patterns.
§ Adequate nutritional needs.
§ Adequate gas exchange needs.
Etiology
The cause of the cyst coledocal still debated. One explanation can be accepted and explained by Babbit. He suggested a linkage between the biliary duct pakreatikus abnormally with the establishment of a "channel" where the secretion of pancreatic enzymes released into the biliary duct wall caused by the vandalism of fragile enzyme that causes gradual dilation, inflammation and eventually formed cysts. But keep in mind that not all cases of cyst formation coledocal show "channel".
Coledocal cyst is more prevalent in women than in men (4: 1). Symptoms commonly called compleks classic symptoms described in the clinical manifestations.
Pathophysiology
There are various explanations and coledocal cyst classification based on the location and anatomy. Classification of the help made by Todani modified from the classification developed by Alonsolej. The first type is characterized by the merger (fusiform) dilated biliary duct where duct cyst in (most common). Coledocal cyst is considered an initial overview of the biliary system disorders pankretikus. Some of the circumstances that are often associated with cysts coledocal is a state jungta pancreatic duct anomalies and large biliary duct, stenosis of the distal biliary duct, intra-hepatic duct dilatation. Histological abnormalities and abnormalities of the biliary ductal histology of normal liver to liver cirrhosis. These figures take place in several stages and the combination of changes in anatomy and malformations.
Clinical Manifestations
The nurse is important to know the clinical manifestations of cystic coledocal, where information obtained during the assessment.
Common signs of cyst called clssic sympton coledocal copleks include pain, a mass, yellow experienced less than half the patients. Signs are more often seen is abdominal pain that often recur after several months or years. Usually only a few shows jaundice. If the condition persists, it can happen colangitis, serosis and portal hypertension.
DIAGNOSTIC TEST
Coledocal cysts in infants or fetuses can be detected by maternal antenatal ultrasound. In adults performed ultrasonography and computerized axial tomography. Endoscopic retrogrde echolangiospancreatography (ERCP) performed in patients when the results are less clear noninfasiv procedures.
Nursing Diagnosis
According to Spark, nursing diagnoses are common in patients with cystic coledocal are:
1. Painful
2. Impaired self kosep
3. Changes in nutrition
4. Impaired gas exchange
Intervention
1. Medical Intervention
Surgery include internal drainage through systerectomy and excision. Morbidity of the action is quite high. Cyst wall consists of connective tissue covered with mucous membrane. Unexpected events is scar tissue obstruction. Furthermore, tissue cysts can not be contracted after drainage.
Morbidity can also disebabka by biliary stasis. Another risk is the growth of malignant due to retention cysts. For this it is recommended cyst resection.
Successful resection require action by inserting a circular dissection plane between the cyst and the portal vein to facilitate removal. In this procedure possible injury to the pancreatic duct. Another alternative procedure can be performed when anatomically porta driven by inflammation.
2. Nursing interventions
Nursing interventions conducted in order to overcome the problem that is described in kperawatan diagnosis and directed to prevent injury. In general, nursing actions include:
§ Reduce pain
§ Assist the patient to recover his self-concept, face and accept reality and to develop problem-solving patterns.
§ Adequate nutritional needs.
§ Adequate gas exchange needs.
