Hepatic Encephalopathy in a Postpartum Patient with Chronic Hepatitis B: A Case Report
DOI:
https://doi.org/10.56951/7n0pqt23Kata Kunci:
sirosis hepatis, hepatitis B kronis, ensefalopati hepatikum, periode postpartum, varises esofagusAbstrak
Sirosis hepatis dekompensata pada periode postpartum merupakan kondisi yang jarang dilaporkan, khususnya bila berhubungan dengan infeksi hepatitis B kronis. Kami melaporkan seorang wanita berusia 33 tahun yang datang dengan penurunan kesadaran satu hari setelah melahirkan. Pasien sebelumnya tidak memiliki riwayat penyakit kronis, namun terdapat riwayat keluarga, yaitu ayahnya meninggal akibat komplikasi hepatitis B. Pemeriksaan klinis menunjukkan kerus, asites, dan ensefalopati hepatikum. Pemeriksaan laboratorium menunjukkan HBsAg reaktif, hipoalbuminemia,
peningkatan enzim hati, hiponatremia, hipokalemia, serta bilirubin total tinggi. USG abdomen menunjukkan sirosis hepatis dengan splenomegali dan asites. Diagnosis ditegakkan sebagai sirosis hepatis Child-Turcotte-Pugh kelas C dengan asites grade II, ensefalopati hepatikum grade II, hepatitis B kronis, dan varises esofagus. Pasien mendapatkan terapi suportif, laktulosa, transfusi albumin, dan antivirus tenofovir, dengan perbaikan klinis dan laboratorium setelah satu bulan. Kasus ini menekankan pentingnya deteksi dini infeksi hepatitis B pada kehamilan untuk mencegah dekompensasi postpartum yang berpotensi fatal.
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