Page 214 - Abstract Book KONIKA 18

Gastroenterohepatology

P-GEH-009
Analysis of Variables that Affect the Understanding and Management
of Infant Regurgitation by Indonesian Pediatricians

Fransesco Bernado Hubert Jonathan , Badriul Hegar , Agus T. Sridevi ,
2
1
1
Brahmantyo A. Wicaksono , Dewi Friska 3
1
3
1
2
Faculty of Medicine , Department of Child Health and Department of Community Medicine , Faculty of Medicine,
Universitas Indonesia, Jakarta, Indonesia
Abstract
Background Diagnostic criteria of infant regurgitation has been well elucidated in the ROME IV criteria and
has also been informed to pediatricians. However, as a functional disease, infant regurgitation is susceptible
for misdiagnosis and inappropriate management. Objective To analyze factors that affect pediatricians’
diagnostic knowledge and therapeutic approach on infant regurgitation. Methods This research applied a
cross-sectional observational analytical study design. A questionnaire was formulized based on Rome IV
for diagnosis and standardized guidelines for management. The questionnaire was face-level validated by
an expert and tested for both reliability and correlation using 30 test respondents. The questionnaire was
then distributed electronically to randomized pediatricians (members of the Indonesian Pediatric Society,
DKI Jakarta branch, who graduated between 2005-2019. This research has also passed ethical clearance.
Data analyses utilized 131 samples with SPSS 20. Results Acquired data is expressed as mean/total
score, median(range). Pediatricians who use Rome IV as their source of knowledge achieved a diagnostic
knowledge score of 14.87/20, 16(8–20) and a therapeutic knowledge score of 9.10/14, 10(4–12). There are no
statistically significant variables related to the scores mentioned earlier, diagnostic knowledge score towards
the usage of ROME IV (SD= 2.540, P=0.110) and therapeutic approach score towards the usage of ROME
IV (SD=2.264, P=0.519). Conclusion The pediatricians have good diagnostic knowledge and therapeutic
approach scores. It is highly likely that the existing variables act together as a multi-factorial variable that
influence the resulting scores.
Keywords: infant regurgitation; FGID; Rome IV

P-GEH-010
Intestinal Malrotation in A Male Adolescent with Obstructive Symptoms:
A Rare Case Report

Kholisah Nasution , Rizky Amaliah , Pramita Gayatri Dwipoerwantoro 1
1
2
1
2
Department of Child Health and Department of Surgery , Faculty of Medicine Universitas Indonesia/Dr. Cipto Man-
gunkusumo General Hospital, Jakarta, Indonesia
Abstract
Background Intestinal malrotation is an anomaly that occurs during fetal development and usually occurs in
the first year of life. An incidence up to 1 % has been reported in adolescence. Objective To describe a rare
case of intestinal malrotation in a teenager presenting with obstructive symptoms. Case A 16-year-old male
teen presented to the emergency room with chronic abdominal pain, followed by signs of intestinal obstruction
of profuse-biliary vomits and constipation. His abdomen showed mild diffuse tenderness to deep palpation.
He lost 5 kilograms in 4 weeks. Upper gastrointestinal water-soluble studies revealed gastric enlargement and
no contrast flow to the duodenum suggesting gastric outlet obstruction. Exploratory laparotomy showed all
intestines were on the posterior of the colon, with the caecum on the lower left while the descendent colon
was on the right posterior, and the Ladd’s band shown in the mesentery of ascending colon and duodenum.
The Ladd’s procedure was performed; consisted of derotation of the volvulus, releasing duodenal obstruction
with straightening of the duodenum along the right abdominal gutter, repositioning the bowels, and removal
of the appendix. On the third day after surgery, he was able to eat solid food and was discharged two days
after. A two-week following up showed he could gain 2 kilograms without vomitus and abdominal pain.
Conclusions A teenager with biliary vomiting should be anticipated as intestinal malrotation. Increased
awareness of this organic cause and possible diverse presentation at different ages may lessen the time to
diagnose and improve the outcomes.
Keywords: malrotation; adolescent; vomit; Ladd’s procedure

166 KONIKA XVIII Abstract Book