Etiologi Dan Patofisiologi Kasus Intractable Hiccups Pada Pasien Laki-Laki 57 Tahun
DOI:
https://doi.org/10.36408/mhjcm.v8i3.676Keywords:
Intractable HiccupsAbstract
Latar belakang : Hiccup adalah hembusan napas yang mengacu dari suara yang dihasilkan kontraksi diafragma dan otot intercostal secara tidak sadar dan mendadak dilanjutkan dengan kontraksi mendadak dari glotis. Hiccup merupakan gejala yang biasa dikenal setiap orang namun tetap merupakan gejala patologis.
Laporan kasus : Dilaporkan laki laki usia 57 tahun dengan cegukan sejak 1 tahun. Pemeriksaan laringoskopi fleksibel menunjukkan adanya LPR (RFS 15). Pasien didiagnosis LPR dan intractable hiccup ec susp gangguan sentral (CNS), diagnosis banding psikogenik. Pasien diberikan terapi metochlopramid dan chlorpromazine selama 5 hari. Hasil evaluasi pasien mengeluh cegukan tidak berkurang. Pasien lalu diberikan terapi omeprazole 20 mg per 12 jam.
Pembahasan : Persistent dan intractable hiccup merupakan gejala yang sulit diobati, bila penyebab diketahui maka diobati sesuai penyebabnya, namun bila penyebab tidak diketahui terapi empiris dilakukan untuk menekan GERD sehingga gejala hiccup perbaikan. Apabila terapi ini gagal agen farmakologi ditujukan ke reseptor dopaminergik dan GABA-ergik.
Kesimpulan : Penatalaksanaan hiccup perlu diketahui etiologi terutama gangguan LPR, GERD dan CNS hingga perlu penanganan multidisipliner dari bagian THT, interna, neurologi dan psikiatri.
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