STUDI KASUS PROSEDUR PEMERIKSAAN OESOPHAGUS MAAG DUODENUM (OMD) PADA PASIEN PEDIATRIK DENGAN KLINIS HYPERTROFI PYLORIC STENOSIS (HPS) DI INSTALASI RADIOLOGI RSUD KOTA SALATIGA
DOI:
https://doi.org/10.51878/healthy.v5i4.14420Keywords:
OMD, Pediatrik, HPS, Media Kontras, RadiografiAbstract
ABSTRACT
Oesophagus Maag Duodenum (OMD) examination in pediatric patients with Hypertrophic Pyloric Stenosis (HPS) requires adjustment because infants have limitations in swallowing contrast media and maintaining position. This study aimed to determine the OMD examination procedure, use of water-soluble iodine contrast mixed with milk, and reasons for focusing examination on the stomach and duodenum. This study used a case study. Data were collected through observation, interviews, and documentation involving four informants: three radiographers and one radiologist at Salatiga City Regional Hospital from October 2025 to April 2026. Data were analyzed through reduction, presentation, and conclusion drawing by comparing findings with theory. The study identified OMD procedure modifications adapted to the infant’s condition and clinical HPS considerations. The examination used conventional radiography without fluoroscopy, iodine contrast mixed with milk at a 1:1 ratio and administered using a baby bottle, with plain AP, post-contrast AP, right lateral, and LPO projections. Examination focused on the stomach and duodenum to evaluate the pylorus. These modifications produced adequate visualization and information. Modified OMD procedures can be an alternative for patients with HPS while considering condition, contrast media safety, and diagnostic needs.
ABSTRAK
Pemeriksaan Oesophagus Maag Duodenum (OMD) pada pasien pediatrik dengan klinis Hypertrophic Pyloric Stenosis (HPS) memerlukan penyesuaian karena keterbatasan bayi dalam menelan media kontras dan mempertahankan posisi. Penelitian bertujuan mengetahui prosedur pemeriksaan OMD, penggunaan media kontras iodium larut air dicampur susu, serta alasan pemeriksaan difokuskan pada lambung dan duodenum. Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus. Data dikumpulkan melalui observasi, wawancara, dan dokumentasi terhadap empat informan, terdiri atas tiga radiografer dan satu dokter spesialis radiologi di RSUD Kota Salatiga pada Oktober 2025–April 2026. Data dianalisis melalui reduksi, penyajian, dan penarikan kesimpulan dengan membandingkan temuan dengan teori. Penelitian menemukan modifikasi prosedur OMD yang disesuaikan dengan kondisi bayi dan pertimbangan klinis HPS. Pemeriksaan menggunakan radiografi konvensional tanpa fluoroskopi, media kontras iodium larut air dicampur susu dengan perbandingan 1:1 dan diberikan melalui botol susu bayi, serta proyeksi AP polos, AP post kontras, Right Lateral, dan LPO. Pemeriksaan difokuskan pada lambung dan duodenum untuk mengevaluasi pylorus. Modifikasi tersebut menghasilkan visualisasi anatomi dan informasi diagnostik memadai pada kasus ini. Modifikasi prosedur OMD dapat menjadi alternatif pemeriksaan pada pasien HPS dengan mempertimbangkan kondisi pasien, keamanan media kontras, dan kebutuhan diagnostik klinis.
References
Brungardt, J. G., & Aguayo, P. (2022). Hypertrophic pyloric stenosis. In P. Mattei (Ed.), Fundamentals of pediatric surgery (3rd ed., pp. 547–552). Springer. https://doi.org/10.1007/978-3-031-07524-7_53
Chen, S., Chen, D., Zhong, W., Jiang, H., Li, Y., Yang, B., Chen, H., Shan, Q., Zhong, Z., Zhou, W., Wang, H., Ma, X., Liu, J., Sun, K., Xie, X., & Zhou, L. (2022). Saline-aided ultrasound versus upper gastrointestinal series in neonates and infants with suspected upper gastrointestinal obstruction: A prospective multicenter comparative study. American Journal of Roentgenology, 218(3), 526–533. https://doi.org/10.2214/AJR.21.26621
Demir, S., Unlu, H. A., Kiris Uzun, G., Oztorun, C. I., Erturk, A., Azili, M. N., & Senel, E. (2024). Effectiveness of two-dimensional shear-wave sonoelastography in the diagnosis and follow-up of infantile hypertrophic pyloric stenosis. Pediatric Surgery International, 40, 161. https://doi.org/10.1007/s00383-024-05738-5
Elvonda, A. P., Liscyaningsih, I. A. N., & Yusninda, A. M. (2024). Studi kasus teknik pemeriksaan radiografi upper gastrointestinal pediatrik dengan klinis suspect hipertrofi pilorus stenosis. Prosiding Seminar Nasional Penelitian dan Pengabdian kepada Masyarakat LPPM Universitas ’Aisyiyah Yogyakarta, 2, 287–291. https://proceeding.unisayogya.ac.id/index.php/prosemnaslppm/article/view/362
Johnson, L. R. (2018). Gastrointestinal physiology (9th ed.). Elsevier. https://shop.elsevier.com/books/gastrointestinal-physiology/johnson/978-0-323-59563-6
Kelimagun, D. F., Istiqomah, A. N., & Maharani, A. (2025). Radiologic technique for esophagus, stomach, and duodenum examination in dysphagia cases: A case study at Panembahan Senopati Bantul Hospital. Jurnal Kesehatan Metro Sai Wawai, 18(1), 70–82. https://doi.org/10.26630/jkmsw.v18i1.5018
Klju?evšek, D., Riccabona, M., Sofia, C., Ording Müller, L.-S., Ozcan, H. N., Perucca, G., Smets, A. M., Stafrace, S., Toso, S., & Petit, P. (2026). European Society of Paediatric Radiology abdominal task force procedural recommendations for upper gastrointestinal contrast fluoroscopy studies in children. Pediatric Radiology. https://doi.org/10.1007/s00247-026-06716-w
Lampignano, J. P., & Kendrick, L. E. (2018). Bontrager’s textbook of radiographic positioning and related anatomy (9th ed.). Elsevier. https://shop.elsevier.com/books/bontragers-textbook-of-radiographic-positioning-and-related-anatomy/lampignano/978-0-323-39966-1
Larasati, D., Astari, F. M., & Dewi, S. N. (2024). Prosedur pemeriksaan oesophagus maag duodenum (OMD) pediatrik pada kasus gastroesophageal reflux disease. Prosiding Seminar Nasional Penelitian dan Pengabdian kepada Masyarakat LPPM Universitas ’Aisyiyah Yogyakarta, 2, 1079–1086. https://proceeding.unisayogya.ac.id/index.php/prosemnaslppm/article/view/487
Nahak, F. T., & Rachmathiany, R. (2023). Teknik pemeriksaan kontras upper gastrointestinal dengan klinis vomiting Instalasi Radiologi RSUD Jombang. Strada Journal of Radiography, 4(1), 29–34. https://doi.org/10.30994/sjr.v4i1.34
Nurasmi, N., Liscyaningsih, I. A. N., & Mufida, W. (2025). Studi kasus prosedur pemeriksaan oesophagus maag duodenum pada klinis kecurigaan achalasia di Instalasi Radiologi RSUD dr. Soeselo Kabupaten Tegal. Knowledge: Jurnal Inovasi Hasil Penelitian dan Pengembangan, 5(4), 1637–1648. https://doi.org/10.51878/knowledge.v5i4.8121
O’Grady, G., Carbone, F., & Tack, J. (2022). Gastric sensorimotor function and its clinical measurement. Neurogastroenterology & Motility, 34(12), e14489. https://doi.org/10.1111/nmo.14489
Sandradilla, D., Anggraeni, A., & Istiqomah, A. N. (2024). Teknik pemeriksaan radiografi oeshopagus maag duodenum (OMD) pada neonatus dengan kasus stenosis pilorus di instalasi radiologi RS Universitas Sebelas Maret Surakarta. Prosiding Seminar Nasional Penelitian dan Pengabdian kepada Masyarakat LPPM Universitas ’Aisyiyah Yogyakarta, 2, 2307–2311. https://proceeding.unisayogya.ac.id/index.php/prosemnaslppm/article/view/389
Tierradentro-Garcia, L. O., Freeman, C. W., Vuma, M., Didier, R. A., Kaplan, S. L., Sze, R., & Hwang, M. (2022). Neonatal gastrointestinal emergencies: A radiological review. Archives de Pédiatrie, 29(3), 159–170. https://doi.org/10.1016/j.arcped.2022.01.016
van den Bunder, F. A., Derikx, J. P. M., Kiblawi, R., van Rijn, R. R., & Dingemann, J. (2022). Diagnostic accuracy of palpation and ultrasonography for diagnosing infantile hypertrophic pyloric stenosis: A systematic review and meta-analysis. British Journal of Radiology, 95(1139), 20211251. https://doi.org/10.1259/bjr.20211251
Venkatakrishna, S. S. B., Elsingergy, M., Calle-Toro, J. S., Dennis, R., Otero, H. J., & Andronikou, S. (2024). Quality and diagnosis on the lateral view of pediatric upper gastro-intestinal series. Children, 11(2), 151. https://doi.org/10.3390/children11020151
Yurizqy, S. D., Yusnida, A. M., & Mahanani, A. (2025). Teknik pemeriksaan oesophagus maag duodenum dengan klinis geriatric syndrome di Instalasi Radiologi Dr. Sardjito. Jurnal Kesehatan Tambusai, 6(2), 7333–7339. https://doi.org/10.31004/jkt.v6i2.45334
