Referat Rara Abses Hepar

7/21/2019 Referat Rara Abses Hepar

http://slidepdf.com/reader/full/referat-rara-abses-hepar 1/18

LAPORAN KASUS DAN REFERAT

“ABSES HEPAR”

OLEH :

Habibi

1102007132

Pembimbing : !" Fi!man#$a%& S'B

KEPANITERAAN KLINIK ILMU BEDAH

RUMAH SAKIT UMUM RIDWAN MAUREKSA

FAKULTAS KEDOKTERAN UNIVERSITAS YARSI

2016



PENDAHULUAN

Abses ha! a"a#ah be$%& !$'e&s! (a"a ha! )a$* "!sebab&a$ +#eh &a,e$a

!$'e&s! ba&e,!- (a,as!- .a/%, /a%(%$ $e&,+s!s se,!# )a$* be,s%/be, "a,! s!se/

*as,+!$es!$a# )a$* "!a$"a! "e$*a$ a"a$)a (,+ses s%(%,as! "e$*a$

(e/be$%&a$ (%s )a$* e,"!,! "a,! .a,!$*a$ ha! $e&,+!&- se#se# !$'#a/as! aa% se#

"a,ah "! "a#a/ (a,e$&!/ ha! 1-2

Abses ha! e,ba*! 2 sea,a %/%/- )a!% abses ha! a/+eb! 3AHA4 "a$ abses

ha! (!+*e$!& 3AHP5 Hepatic Abcess, Bacterial Liver Abcess4 AHA /e,%(a&a$

sa#ah sa% &+/(#!&as! a/+eb!as!s e&s,a!$es!$a# AHA e,%a/a "!sebab&a$ +#eh

Entamoeba Histolytica. 2

AHP "!&e$a# .%*a seba*a! hepatic abscess, bacterial liver abscess,

bacterial abscess of the liver, bacterial hepatic abscess AHP !$! /e,%(a&a$ &as%s )a$*

,e#a!' .a,a$* AHP !$! e,seba, "! se#%,%h "%$!a- "a$ e,ba$)a& "! "ae,ah ,+(!s

"e$*a$ &+$"!s! h!*!e$e5sa$!as! )a$* &%,a$* 2

P,ea#e$s! )a$* !$**! sa$*a e,a h%b%$*a$$)a "e$*a$ sa$!as! )a$*

b%,%&- sa%s e&+$+/! )a$* ,e$"ah se,a *!7! )a$* b%,%& Me$!$*&a$)a a,%s%,ba$!sas! /e$)ebab&a$ be,a/bah$)a &as%s abses ha! "! "ae,ah (e,&+aa$ D!

$e*a,a )a$* se"a$* be,&e/ba$* abses ha! a/%ba #eb!h se,!$* "!"a(a&a$ sea,a

e$"e/!& "!ba$"!$*&a$ "e$*a$ abses ha! (!+*e$!& 2

1



ANATO() DAN F)S)OLO*) HEPAR

Ha! a"a#ah &e#e$.a, e,besa, "a#a/ %b%h- be,a ,aa,aa se&!a,

1800*, aa% 2 9 be,a ba"a$ +,a$* "easa $+,/a# Lea&$)a seba*!a$ besa, "!

,e*!+ h!(+&+$",!a "e&s,a- e(!*as,!&a- "a$ seba*!a$ &e!# "! h!(+&+$",!a

s!$!s,a Ha! /e/!#!&! "%a #+b%s %a/a )a!% &a$a$ "a$ &!,! L+b%s &a$a$

"!ba*! /e$.a"! se*/e$ a$e,!+, "a$ (+se,!+, +#eh '!s%,a se*/e$a#!s &a$a$

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'a#s!'+,/!s D! baah (e,!+$!%/ e,"a(a .a,!$*a$ !&a (a"a )a$* "!seb%

kapsula Glisson )a$* /e#!(%! se#%,%h (e,/%&aa$ ha! Se!a( #+b%s ha!

e,ba*! /e$.a"! s,%&%,s,%&%, )a$* "!seb% seba*a! #+b%#%s- )a$*

/e,%(a&a$ %$! /!&,+s&+(!s "a$ '%$*s!+$a# +,*a$ )a$* e,"!,! aas #e/(e$*

#e/(e$* se# ha! "!/a$a "!a$a,a$)a e,"a(a s!$%s+!" Se#a!$ se#se# ha!-

s!$%s+!" e$a "!#a(!s! +#eh se# e$"+e# &h%s%s "a$ se# Kupffer )a$* /e,%(a&a$

/a&,+'a* )a$* /e#a(!s! s!$%s+!" "a$ /a/(% /e/'a*+s!+s!s ba&e,! "a$

be$"a as!$* #a!$ "a#a/ "a,ah s!$%s he(a!&%s Ha! /e/!#!&! s%(#a! "a,ah "a,!

sa#%,a$ e,$a "a$ #!/(a /e#a#%! e$a (+,a he(a!&a "a$ "a,! a+,a /e#a#%!

a,e,!a he(a!&a 32-;-<4

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"a#a/ %s%s

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Penimb,nan i+amin an mine!a/

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B12 .%*a "!s!/(a$ sea,a $+,/a#

Hati menyimpan besi dalam bentuk ferritin

Se# ha! /e$*a$"%$* se.%/#ah besa, (,+e!$ )a$* "!seb% apoferritin- )a$*

"a(a be,*ab%$* "e$*a$ bes! ba!& "a#a/ .%/#ah se"!&! /a%(%$ ba$)a&

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a&a$ be,!&aa$ "e$*a$ a(+'e,,!!$ /e/be$%& 'e,,!!$ "a$ "!s!/(a$ "a#a/

be$%& !$! "! "a#a/ se# ha! sa/(a! "!(e,#%&a$ B!#a bes! "a#a/ s!,&%#as!

a!,a$ %b%h /e$a(a! &a"a, ,e$"ah- /a&a 'e,,!!$ a&a$ /e#e(as&a$ bes!

Hati membentuk zatzat yan! di!unakan untuk koa!ulasi darah dalam

"umlah banyak

>a7a )a$* "!be$%& "! ha! )a$* "!*%$a&a$ (a"a (,+ses &+a*%#as!

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bebe,a(a 'a&+, &+a*%#as! #a!$$)a V!a/!$ K "!b%%h&a$ +#eh (,+ses

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Ha+i menge/,a!-an a+a, menge-#-!e#i-an .ba+4.ba+an& %.!m.n& an 5a+

/ain

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"e+&s!'!&as! aa% e&s&,es! be,ba*a! +ba+baa$ /e#!(%! s%#'+$a/!"-

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"a,ah e&s,a "! saa &e&%,a$*a$ +#%/e "a,ah S!$%s+!" ha! /e,%(a&a$ "e(+

"a,ah )a$* /e$*a#!, &e/ba#! "a,! e$a aa 3*a*a# .a$%$* &a$a$4 &e,.a

'a*+s!!& se# K%(''e, /e/b%a$* ba&e,! "a$ "eb,!s "a,! "a,ah

ET)OLO*) DAN PATO*ENES)S

Ab#e# Ha+i Am,ba

E. Histolytica /e/(%$)a! "%a be$%&- )a&$! ,+'+7+! "a$ &!saBe$%&

&!sa /e,%(a&a$ s%/be, (e$%#a,a$ "a$ /as%& &e "a#a/ %b%h ,$e#a#%! /a&a$a$

aa% /!$%/a$ Da#a/ %s%s- be$,%& &!sa !$! be,%bah /e$!a"! ,+'+7+!" T,+'+7+!

&e,$%"!a$ be,&e/ba$*- b!#a /e$e/b%s /%&+sa- ,+'+7+! /e$)ebab&a$ %&a&

(a"a /%&+sa &+#+$ Abses a/%ba ha! e,.a"! &a,e$a ,+'+7+! Eh!s+#)!a "a,!

"!$"!$* %s%s e,baa a#!,a$ e$a (+,a &e ha! e,a(! !"a& se/%a a/%ba )a$*

/as%& &e ha! "a(a /e$!/b%#&a$ abses A*a, e,.a"! abses-"!(e,#%&a$ 'a&+,

(e$"%&%$* aa% (e$*ha#a$* be,&e/ba$* b!a&$)a a/%ba e,seb% Fa&+, e,seb%

a$a,a #a!$ a"a#ah ,!a)a !$'e&s! a/%ba- !$**!$)a &a"a, &+#es,e,+#- ,!a)a

(asa ,a%/a ha!- "a$ &ea*!ha$ a#+h+# Te,.a"! ,ea&s! ,a"a$* "! ha!- )a$*

a&h!,$)a "!!&%! +#eh $e&,+s!s .a,!$*a$ (,+ses (e$a!,a$ .a,!$*a$ $e&,+s!s

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abses )a$* be,!s! a!,a$ /e,ah +&#a 3a$hh%) sa%e4 a& be,ba%- &a,e$a

/e,%(a&a$ (,+"%& #!s!s .a,!$*a$ $e&,+s!s "a$ (e,"a,aha$ @a!,a$ !$! e,b%$*&%s+#eh h)(e,(#as!a .a,!$*a$ !&a )a$* "!seb% s!/(a! a#a%(%$ b%&a$ be,%(a s!/a(!

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8



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s!/(a!$)a

Ab#e# Pi.geni-

Abses ha! "a(a be,asa# "a,! ,a"a$* b!#!e,- "a,! "ae,ah s(#a$&$!& /e#a#%! e$a

(+,,a 3se(e,! a(e$"!s!!s a&% "a$ "!e,!&%#!!s a&%4- aa% s!se/!& "a,! /a$a(%$

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"!sebab&a$ +#eh ,a%/a aa% !$'e&s! #a$*s%$* ha! aa% s!se/ "! se&!a,$)a

Sebe#%/ e,a a$!b!+,!&- se(s!s !$,aab"+/e$- e,%a/a a(e$"!s!!s- "!e,!&%#!!s-

"!se$,! bas!#e,- !$'e&s! "ae,ah (e#!&- he/+,+!" )a$* e,!$'e&s!- "a$ abses

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seba*a! (!#e'#eb!!s (e,!'e, "!se,a! (e,$a$aha$ "a$ ,+/b+s!s )a$* &e/%"!a$

/e$)eba, /e#a#%! a#!,a$ (+,a &e "a#a/ ha! Abses ha! "a(a ,e,.a"! a&!ba

(e$)eba,a$ #a$*s%$* !$'e&s! "a,! s,%&%, )a$* be,"e&aa$ se(e,! e/(!e/a

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K+#es!s!!s a&% "a$ (a$&,ea!!s a&% .%*a "a(a /e$)ebab&a$ abses ha!

(!+*e$!& I$'e&s! (a"a sa#%,a$ e/(e"% )a$* /e$*a#a/! +bs,%&s! $a!& &e aba$*

sa#%,a$ e/(e"% !$,ahe(a!& /e$)ebab&a$ &+#a$*!!s )a$* /e$!/b%#&a$

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&e!# "! &e"%a #+b%s ha! Abses ha! (!+*e$!& "a(a /e,%(a&a$ (e$)%#! "a,!

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6



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(!+*e$!& /%#!(#e e,"a(a (a"a 809 &as%s Ha! a/(a& /e/be$*&a& "a$ "ae,ah

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e,sa/a,4C

(AN)FESTAS) KL)N)S

Ab#e# He'a! Am.eba

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Ab#e# Pi.geni-

Sea,a &#!$!s- *e.a#a $+$s(es!'!& )a$* !/b%# /e#!(%! "e/a/ )a$* $a!& %,%$-

/a#a!se- /%a#- ,asa #e/ah- a$+,e&s!a- (e$%,%$a$ be,a ba"a$- $)e,! &e(a#a- $)e,!

++ "a$ se$"!- se,a $)e,! (e,% N)e,! (e,% e,%a/a "!,asa&a$ "! baah !*a

&a$a$ aa% (a"a &%a",a$ &a$a$ aas Da(a "!.%/(a! *e.a#a "a$ a$"a e'%s! (#e%,a

B!#a e,be$%& "e&a "!a',a*/a- "a(a !/b%# *e.a#a $)e,! se(e,! (#e%,!!s "e$*a$

ba%& "a$ sesa& N)e,! se,!$* be,&%,a$* b!#a (e$"e,!a be,ba,!$* (a"a s!s! &a$a$

De/a/ h!#a$* !/b%# aa% /e$ea( be,*a$%$* (a"a .e$!s abses "a$ &%/a$

(e$)ebab$)a Da(a e,.a"! !&e,%s- as!es- "a$ "!a,e I&e,%s e,%a/a e,"a(a

(a"a abses ha! (!+*e$!& &a,e$a (e$)a&! sa#%,a$ e/(e"% )a$* "!se,a! "e$*a$

&+#a$*!!s s%(%,a!a "a$ (e/be$!%&a$ abses /%#!(#e e$!s !$! (,+*$+s!s$)a

b%,%& Pa"a (e/e,!&saa$ /%$*&!$ "!"a(a he(a+/e*a#! aa% &ee*a$*a$ (a"a

(e,% &%a",a$ #ae,a# aas ab"+/e$ aa% (e/be$*&a&a$ (a"a "ae,ah !$e,&+sa#

Kee*a$*a$ #eb!h $)aa (a"a (e,&%s! A(ab!#a abses e,"a(a (a"a #+b%s &!,!-

/%$*&!$ "a(a "!,aba %/+, "! e(!*as,!%/ Da(a e,.a"! (e$)%#! be,%(a

(eah$)a abses &e "a#a/ ,+$**a (e,%- ,+$**a "a"a- aa% (e,!&a," Da(a (%#a

e,.a"! se(!se/!a "a$ s)+& A&a$ ea(!- ba$)a& ba$)a& .%*a !"a& /e$%$.%&&a$

*e.a#a &has O#eh &a,e$a !%- &e/%$*&!$a$ abses ha! (!+*e$!& (a% "!(!&!,&a$

(a"a se!a( (e$"e,!a "e$*a$ "e/a/ a$(a sebab )a$* .e#as- e,%a/a (asabe"ah

ab"+/e$C



D)A*NOS)S

A/g.!i+ma 'enega--an iagn.#i#



Peme!i-#aan Lab.!a+.!i,m

Pa"a (as!e$ abses ha! a/eb!&- (e/e,!&saa$ he/a+#+*! "!"a(a&a$

he/+*#+b!$ 10-<11-; *9 se"a$*&a$ #e&+s! 18000160005/L; (a"a

(e/e,!&saa$ 'aa# ha! "!"a(a&a$ a#b%/!$ 2-C6;-08 *9- *#+b%#!$ ;-62

;-C8 *9- +a# b!#!,%b!$ 0-2-<< /*9- '+s'aase a#&a#! 2C0-<;2-0 %5L-

S=OT 2C-88- %5L "a$ S=PT 18-C6;-0 %5L a"! &e#a!$a$ )a$*

"!"a(a&a$ (a"a a/%b!as!s ha! a"a#ah a$e/!a ,!$*a$ sa/(a! se"a$*-

#e%&+s!+s!s be,&!sa, 180005/L; Se"a$*&a$ &e#a!$a$ 'aa# ha! "!"a(a&a$

,!$*a$ sa/(a! se"a$* U.! se,+#+*! "a$ %.! &%#! )a$* (+s!!' /e$%$.%&&a$

a"a$)a A* aa% Ab )a$* s(es!'!& e,ha"a( (a,as! !$!- &e%a#! (a"a aa#

!$'e&s! A"a bebe,a(a %.! )a$* ba$)a& "!*%$a&a$ a$a,a #a!$

hema!lutination 3IHA4- countermunoelectrophoresis 3@IE4- "a$ ELISA

#eal $ime %&# ++& %$%& /e$"ee&s! Eh!s+#!)a (a"a 'eses "a$ (%s

(e$"e,!a abses he(a, 2-C

Pa"a (as!e$ abses ha! (!+*e$!&- /%$*&!$ "!"a(a&a$ #e%&+s!+s!s

"e$*a$ (e,*ese,a$ &e &!,!- a$e/!a- (e$!$*&aa$ #a.% e$"a( "a,ah-

*a$**%a$ '%$*s! ha! se(e,! (e$!$**!a$ b!#!,%b!$- a#&a#!$ '+s'aase-

(e$!$*&aa$ e$7!/ ,a$sa/!$ase- se,%/ b!#!,%b!$- be,&%,a$*$)a

&+$se$,as! a#b%/!$ se,%/ "a$ a&% (,+,+/b!$ )a$* /e/a$.a$*

/e$%$.%&&a$ baha e,"a(a &e*a*a#a$ '%$*s! ha! K%#%, "a,ah )a$*

/e/(e,#!ha&a$ ba&e,!a# (e$)ebab /e$.a"! sa$"a, e/as %$%&

/e$e*a&&a$ "!a*$+s!s sea,a /!&,+b!+#+*!& Pe/e,!&saa$ b!a&a$ (a"a

(e,/%#aa$ (e$)a&! se,!$* !"a& "!e/%&a$ &%/a$ K%/a$ )a$* se,!$*

"!e/%&a$ a"a#ah &%/a$ *,a/ $e*a!' se(e,! %roteus vul!aris, Aerobacter aero!enes aa% %seudomonas aeru!inosa, se"a$*&a$ &%/a$

a$ae,!b 'icroaerofilic sp, (treptococci sp, Bacteroides sp, aa%

)usobacterium sp. 1-2

Peme!i-#aan Rai./.gi

Pa"a (as!e$ abses ha! a/eb!&- '++ h+,a&s /e$%$.%&&a$

(e$!$**!a$ &%bah "!a',a*/a &a$a$ "a$ be,&%,a$*$)a (e,*e,a&a$

"!a',a*/a e'%s! (#e%,a &+#a(s (a,% "a$ abses (a,% Ke#a!$a$ (a"a '++

10



(+#+s ab"+/e$ !"a& be*!% ba$)a& M%$*&!$ be,%(a *a/ba,a$ !#e%s-

he(a+/e*a#! aa% *a/ba,a$ %"a,a bebas "! aas ha! a,a$* "!"a(a&a$

a!, '#%!" #ee# )a$* .e#as- US= %$%& /e$"ee&s! a/%b!as!s ha!- US=

sa/a e'e&!'$)a "e$*a$ @T aa% MRI =a/ba,a$ US= (a"a a/%b!as!s

ha! a"a#ah be$%& b%#a aa% +a# !"a& a"a *e/a "!$"!$* )a$* be,a,!

e&+*e$!as #eb!h ,e$"ah "a,! (a,e$&!/ ha! $+,/a# be,se$%ha$ "e$*a$

&a(s%# ha! "a$ (e$!$**!a$ sonic distal. =a/ba,a$ @T sa$ : 8 9 be,%(a

/assa s+#!e, ,e#a!' besa,- /+$+#+&%#a,- (,a&+$,as a/(a& seba*a! /assa

h!(+"e$s be,baas s%,a/ De$s!as a!,a$ abses be,&!sa, 1020 HU Pasa

&+$,as a/(a& (e$)e$*aa$ (a"a "!$"!$* abses )a$* eba# Se(a e,#!ha

(a"a ;0 9 &as%s Pe$)e$*aa$ "!$"!$* e,#!ha ba!& (a"a 'ase (+,a 2

Gambaran CT Scan pada abses hati amebic

Pa"a (as!e$ abses ha! (!+*e$!&- '++ (+#+s ab"+/e$ &a"a$*&a"a$*

"!"a(a&a$ &e#a!$a$ )a$* !"a& s(es!'!& se(e,! (e$!$**!a$ "!a',a*/a

&a$a$- e'%s! (#e%,a- ae#e&as!s basa# (a,%- e/(!e/a- aa% abses (a,% Pa"a

'++ h+,a&s PA- s%"% &a,"!+',e$!&%s e,%%(- (a"a (+s!s! #ae,a# s%"%

&+s+',e$!&%s a$e,!+, e,%%( Sea,a a$*!+*,a'!& abses /e,%(a&a$

"ae,ah aas&%#e, Ka"a$*&a"a$* "!"a(a&a$ *as aa% a!,a$ (a"a

s%b"!a',a*/a &a$a$ Pe/e,!&saa$ US=- ,a"!+$%#!"e sa$$!$*- @T sa$

"a$ MRI /e/(%$)a! $!#a! "!a*$+s!s )a$* !$**! @T sa$ "a$ MRI "a(a

/e$ea(&a$ #+&as! abses #eb!h a&%,a e,%a/a %$%& ",a!$ase (e,&%a$

aa% !$"a&a$ be"ah =a/ba,a$ @T sa$ : a(ab!#a /!&,+abses be,%(a #es!

h!(+"e$s &e!#&e!# G 8 // s%&a, "!be"a&a$ "a,! /!&,+abses .a/%,- ,!/

e$ha$e/e$ (a"a /!&,+abses s%&a, "!$!#a! &a,e$a #es! e,#a#% &e!#

A(ab!#a /!&,+abses 10 // aa% /e/be$%& &#%se, seh!$**a a/(a&

11



/assa a*a& besa, /a&a (,a&+$,as &#%se, (!+*e$!& abses a/(a& seba*a!

/asa lo* density be,baas s%,a/ Pasa &+$,as 'ase a,e,!a# a/(a&

*a/ba,a$ &has be,%(a /asa "e$*a$ rim enhancement "!/a$a ha$)a

&a(s%# abses )a$* eba# )a$* /e$)e$*a Ba*!a$ e$*ah abses e,#!ha

h!(+"e$s "e$*a$ ba$)a& se(ase(a ha#%s )a$* .%*a /e$)e$*a- seh!$**a

/e/be$%& *a/ba,a$ /e$)e,%(a! .a#a Fase (+,a (e$)e$*aa$ "!$"!$*

&a(s%# abses a&a$ se/a&!$ /e$+$.+# "a$ se&!a, "!$"!$* abses a/(a&

a,ea )a$* h!(+"e$s seba*a! ,ea&s! e"e/a "! se&!a, abses Seba*!a$ &e!#

(!+*e$!& be,s!'a /+$+&%#e,- !"a& be,se(a- "a$ /e$)e,%(a! abses

a/+eb!as!s Pe/be$%&a$ *as "! "a#a/ abses b!asa$)a (a"a !$'e&s! +#eh

&%/a$ K#ebs!e##a 1-2

Gambaran CT Scan dengan multifokal abses hati piogenik pada segmen IV. Abseslainnya terdapat pada segmen VII dan VIII )

Ka,ae,!s!& abses (a"a (e/e,!&saa$ MRI a"a#ah #es! "e$*a$

(e$)e$*aa$ &+$,as )a$* be,be$%& !$!$ "a$ ba*!a$ se$,a# )a$* !"a&

a/(a& (e$)e$*aa$ @!$!$ (e$)e$*aa$ ea( e,#!ha (a"a 'ase %$"a

Sa$*a s%&a, "!be"a&a$ *a/ba,a$ US= a$a,a abses (!+*e$!& "a$ a/eb!&

B!asa$)a sa$*a besa,- &a"a$*&a"a$* /%#!#+&%#a, S,%&%, e&+ ,e$"ah

sa/(a! a!,a$ 3a$e&+!&4 "e$*a$ a"a$)a be,a&be,a& h!(e,e&+!& 3"eb,!s4

"! "a#a/$)a Te(!$)a e*as- !,e*%#e, )a$* /a&!$ #a/a /a&!$ be,a/bah

eba# 2

12



D)A*NOS)S BAND)N*

Pe$)a&! #a!$ )a$* *e.a#a$)a /!,!( "e$*a$ abses he(a, a$a,a #a!$- &+#es!s!!s

a&%- he(a!!s !,%s a&%- he(a+/a $e&,+!&- "a$ &a,s!$+/a (,!/e, !(e 'eb,!#

U$%& /e/as!&a$ "!a*$+s!s- (e,#% "!#!ha has!# (e/e,!&saa$ %#,as+$+*,a'!-

(%$*s!- "a$ (e,+baa$ (e$*+baa$ "e$*a$ a/%b!s!" )a$* /e,%(a&a$ "!a*$+s!s

(e, e&s#%s!+$e/C

TATALAKSANA

Me,+$!"a7+# /e,%(a&a$ +ba (!#!ha$ "e$*a$ "+s!s ; &a#! C80 /*!a(

ha,!$)a (a"a +,a$* "easa- "a$ ;880 /*5 &*bb "!ba*! "a#a/ ; "+s!s (a"a

a$a&-"!be,!&a$ se#a/a 6 ha,! B!#a !"a& "a(a "!be,!&a$ (e, +,a#- +ba "a(a

"!be,!&a$ /e#a#%! (a,e$e,a# !$,ae$a seba$)a& 800 /* !a( 12 .a/ Se&!a,

<9 (e$"e,!a /e$%$.%&&a$ )a$* ba!& "a#a/ C2 .a/ K#+,+&%!$ '+s'aase

/e,%(a&a$ a$!a/%ba e&s,a!$es!$a# "a$ "!be,!&a$ "a#a/ "+s!s 1 *,a/ !a( ha,!

se#a/a ;ha,!- "!#a$.%&a$ "e$*a$ 800 /* !a( ha,! se#a/a 2; /!$**% Te,a(!

be"ah be,%(a as(!,as! "a$ (e$)a#!,a$ Te&$!& as(!,as! "a(a "!#a&%&a$ sea,a b%a-

ea(! seba!&$)a seba*a! %$%$a$ %#,as+$+*,a'! seh!$**a "a(a /e$ a(a!

%%$a$ "e$*a$ e(a As(!,as! "a(a "!#a&%&a$ be,%#a$*%#a$* sea,a e,%%( aa%

"!#a$.%&a$ "e$*a$ (e/asa$*a$ &aee, (e$)a#!, Pa"a se/%a !$"a&a$ ha,%s

"(e,ha!&a$ (,+se"%, ase(!& "a$ a$!se(! %$%& /e$e*ah !$'e&s! se&%$"e,

@a,a as(!,as! /e$*%$%$*&a$ &a,e$a !"a& /e$**a$**% '%$*s! !a# &e$)a/a$a$

(e$"e,!a !"a& /e$)ebab&a$ &+$a/!$as! ,+$**a (e#!+$e%/ "a$ /%,ah As(!,as!

ha,%s "!#a&%&a$ "e$*a$ &aee, )a$* %&%( besa, K+$,a!$"!&as! a"a#ah as!es

"a$ s,%&%, !a# /e$*ha#a$*! .a#a$$)a .a,%/ &+$,+e,s! e$a$* "!#a&%&a$

as(!,as! "!#a$.%&a$ "e$*a$ ",a!$ase aa% %&%( +ba a$!/%ba sa.a Saa !$!-

e,a(! as(!,as! "a(a "!#a&%&a$ (a"a &ea"aa$ &e!&a 314 se,+#+*! a/%ba!"a&

/e$e$%&a$ "!a*$+s!s ba$"!$* %a/a a"a#ah abses ha! (!+*e$!&- 324 (e/be,!a$

a$!a/%ba "!a$**a( &%,a$* e(a (a"a &eha/!#a$ 3;4 "!"%*a e,.a"! !$'e&s!

se&%$"e, (a"a 189 &as%s- 3<4 "e/a/ "a$ $)e,! ea( "!,asa ;8 ha,! (asae,a(!-

"a$ 384 b!#a "!$)aa&a$ e,"a(a baha)a (eah "a$ abses besa, 38/4 B!#a

"!(e,#%&a$- "a(a "!(asa$* ",a!$ (e,&%a$ "e$*a$ ",a!$ase e,%%(C

1;



Pen$a/i%an (e/a/,i La'a!.+.mi" Pe$)a#!,a$ e,b%&a "!#a&%&a$ b!#a

(e$*+baa$ *a*a# "e$*a$ e,a(! &+$se,a!'- e,/as%& as(#,as! be,%#a$* I$"!&as!

#a!$ a"a#ah abses ha! #+b%s &!,! )a$* e,a$a/ (eah &e ,+$**a (e,!+$e%/ "a$

&e +,*a$ #a!$ e,/as%& &e "!$"!$* (e,%- "a$ !$'e&s! se&%$"e, )a$* !"a&

e,&e$"a#! A$*&a &e/a!a$ "e$*a$ a,a !$! #eb!h !$**! !&a !$"a&a$ #a(a,++/!

"!b%%h&a$- /a&a "!#a&%&a$ "e$*a$ sa)aa$ s%b&+sa# &a$a$ Abses "!b%&a-

"!#a&%&a$ (e$)a#!,a$- "!%! "e$*a$ #a,%a$ *a,a/ '!s!+#+*!& "a$ #a,%a$

a$!b!+!& se,a "e$*a$ %#,as+$+*,a'! !$,a+(e,a!' C

KO(PL)KAS)

Ab#e# He'a! Am.eba

K+/(#!&as! )a$* (a#!$* se,!$* a"a#ah ,%(%, abses sebesa, 8 8-6 9

R%(%, "a(a e,.a"! &e (#e%,a- (a,%- (e,!&a,"!%/- %s%s- !$,a(e,!+$ea# aa%

&%#! Ka"a$*&a"a$* "a(a e,.a"! s%(e,!$'e&s!- e,%a/a see#ah as(!,as! aa%

",a!$ase I$'e&s! (#e%,+($e%/+$a# a"a#ah &+/(#!&as! )a$* (a#!$* %/%/

e,.a"! Me&a$!s/e !$'e&s! e,/as%& (e$*e/ba$*a$ e'%s! se,+sa s!/(a!&-

(eah$)a abses ha! &e "a#a/ ,+$**a "a"a )a$* "a(a /e$)ebab&a$

e/(!e/a- se,a (e$)eba,a$ he/a+*e$ seh!$**a e,.a"! !$'e&s! (a,e$&!/

F!s%#a he(a+b,+$&!a# "a(a /e$)ebab&a$ ba%& (,+"%&!' "e$*a$ baha$

$e&,+!& /e$*a$"%$* a/+eba F!s%#a b,+$&+(#e%,a# /%$*&!$ .a,a$* e,.a"!

K+/(#!&as! (a"a .a$%$* b!asa$)a "!&a!&a$ (eah$)a abses (a"a #+b%s &!,!

ha! "!/a$a !$! "a(a /e$!/b%#&a$ &e/a!a$ Peah aa% ,%(%,$)a abses

"a(a &e +,*a$+,*a$ (e,!+$!%/ "a$ /e"!as!$%/ Kas%s (se%"+a$e%,)s/

a,e,! he(a!&a e#ah "!#a(+,&a$ e,.a"! seba*a! &+/(#!&as! 6

Ab#e# He'a! Pi.geni-

Saa "!a*$+s!s "!e*a&&a$- /e$**a/ba,&a$ &ea"aa$ (e$)a&! be,a se(e,!

se(!&a/!a5ba&e,!/!a "e$*a$ /+,a#!as 89- ,%(%, abses ha! "!se,a!

(e,!+$!!s *e$e,a#!saa "e$*a$ /+,a#!as 6C9- &e#a!$a$ (#e%,+(%#/+$a#-

*a*a# ha!- (e,"a,aha$ &e "a#a/ ,+$**a abses- he/+b!#!a- e/(!e/a- '!s%#a

he(a+b,+$&!a#- ,%(%, &e "a#a/ (e,!&a," aa% ,e,+(e,!$e%/ Ses%"ah

1<



/e$"a(a&a$ e,a(!- se,!$* e,.a"! "!aes!s he/+,a*!&- !$'e&s! #%&a- abses

,e&%,e$- (e,"a,aha$ se&%$"e, "a$ e,.a"! ,e&%,e$s! aa% ,ea&!'as! abses 2

PRO*NOS)S

Pa"a &as%s AHA- se.a& "!*%$a&a$ +ba se(e,! "eh!",+e/e!$ aa% e/e!$-

/e,+$!"a7+#e "a$ &#+,+%!$- /+,a#!as /e$%,%$ a.a/ M+,a#!as "! ,%/ah

sa&! "e$*a$ 'as!#!as /e$%,%$ a.a/ M+,a#!as "! ,%/ah sa&! "e$*a$

'as!#!as /e/a"a! se&!a, 29 "a$ (a"a 'as!#!as )a$* &%,a$* /e/a"a!

/+,a#!as$)a 109 Pa"a &as%s )a$* /e/b%%h&a$ !$"a&a$ +(e,as!/+,a#!as se&!a, 129 !&a a"a (e,!+$!!s a/%ba- /+,a#!as "a(a /e$a(a!

<0809 Ke/a!a$ )a$* !$**! !$! "!sebab&a$ &ea"aa$ %/%/ )a$* .e#e&-

/a#$%,!s!- !&e,%s- "a$ ,e$.aa$ Sebab &e/a!a$ b!asa$)a se(s!s aa% s!$",+/

he(a+,e$a# Se#a!$ !%- (,+*$+s!s (e$)a&! !$! .%*a "!(e$*a,%h! +#eh !,%#e$s!

(e$)a&!- sa%s !/%$!as- %s!a #a$.%- #ea& se,a .%/#ah abses "a$ e,"a(a$)a

&+/(#!&as! Ke/a!a$ e,.a"! (a"a se&!a, 89 (as!e$ "e$*a$ !$'e&s!

e&,a!$es!$a#- se,a !$'e&s! (e,!+$!a# "a$ (e,!&a,"!%/ 2

P,+*$+s!s abses (!+*e$!& sa$*a "!e$%&a$ "!a*$+s!s "!$!- #+&as! )a$*

a&%,a "e$*a$ %#,as+$+*,a'!- (e,ba!&a$ "a#a/ /!&,+b!+#+*! se(e,! &%#%,

a$ae,+b- (e/be,!a$ a$!b!+!& (e,!+(e,a!' "a$ as(!,as! (e,&%a$ aa% ",a!$ase

sea,a be"ah Fa&+, %a/a )a$* /e$e$%&a$ /+,a#!as a$a,a #a!$ %/%,-

.%/#ah abses- a"a$)a &+/(#!&as! se,a ba&e,!/!a (+#!/!&,+b!a# "a$ *a$**%a$

'%$*s! ha! se(e,! !&e,%s aa% h!(+a#b%/!$e/!a K+/(#!&as! )a$* be,a&h!,

/+,a#!as e,.a"! (a"a &ea"aa$ se(s!s abses s%b',e$!& aa% s%bhe(a!&- ,%(%,

abses &e ,+$**a (e,!+$!%/- &e (#e%,a aa% &e (a,%- &e*a*a#a$ ha!- he/+b!#!a-

"a$ (e,"a,aha$ "a#a/ abses ha! Pe$)a&! (e$)e,a )a$* /e$)ebab&a$

/+,a#!as !$**! a"a#ah DM- (e$)a&! (+#!&!s!& "a$ s!,+s!s ha! M+,a#!as

abses ha! (!+*e$!& )a$* "!+ba! "e$*a$ a$!b!+!&a )a$* ses%a! ba&e,!a#

(e$)ebab "a$ "!#a&%&a$ ",a!$ase a"a#ah 1016 9 P,+*$+s!s b%,%& a(ab!#a:

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18



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16



DAFTAR PUSTAKA

1 We$as-Ne##) Te$"ea$ Wa#e#e$*-B Abses ha! (!+*e$!& Da#a/ :

S%"+)+-A,% W Se!)+ha"!-Ba/ba$* A#!-I",%s S!/a"!b,aa-Ma,e##%s

Se!a!-S!! B%&% a.a, !#/% (e$)a&! "a#a/ .!#!" I e"!s! IV a&a,a : P%sa

Pe$e,b!a$ De(a,e/e$ I#/% Pe$)a&! Da#a/ Fa&%#as Ke"+&e,a$

U$!e,s!as I$"+$es!a 2010 Ha# <60<61

2 L!$"seh- =#e$"a N =a$**%a$ ha!- &a$"%$* e/(e"%- "a$ (a$&,eas

Da#a/ : P,!e- S)#!a A W!#s+$- L+,,a!$e M Pa+'!s!+#+*! &+$se( &#!$!s

(,+ses(,+ses (e$)a&! +#1 e"!s! 6 a&a,a : E=@ 2006 Ha# <C2<C6

; =%)+$- A,h%, @ Ha##- +h$ E Ha! seba*a! s%a% +,*a$ Da#a/ : B%&%

a.a, '!s!+#+*! &e"+&e,a$ e"!s! 11 a&a,a : E=@ 200 Ha# 0206

< S.a/s%h!"a.a-R "e+$*- W!/ B%&% A.a, I#/% Be"ah a&a,a : E=@

Pe$e,b! B%&% Ke"+&e,a$ 2011

1C

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