PROSEDUR PEMERIKSAAN LOPOGRAFI DENGAN KLINIS POST COLOSTOMY HIRSCHPRUNG PADA PASIEN PEDIATRIK DI RSD K.R.M.T WONGSONEGORO

Abstract

ABSTRACT

Lopography examination in pediatric patients with clinical post-colostomy Hirschsprung is performed to obtain images of colonic anatomy and contrast-medium distribution as a basis for evaluating the patient’s condition before further management. This study aimed to describe the lopography examination procedure and the rationale for not performing post-evacuation imaging in pediatric patients with clinical post-colostomy Hirschsprung. A descriptive qualitative method with a case study approach was employed at the Radiology Installation of RSD K.R.M.T. Wongsonegoro Semarang from September 2025 to May 2026. Data were collected through observation, interviews, documentation, and literature review involving three radiographers and one radiologist. The findings showed that patient preparation included data verification, cleaning of the stoma area, removal of the stoma bag, changing clothes, and completion of informed consent. The contrast medium consisted of iodine water-soluble contrast and NaCl at a ratio of 1:4, while imaging was performed using plain AP, AP post-contrast, and lateral projections. Post-evacuation imaging was not performed because the contrast medium was water-soluble and could be expelled from the body, while radiation exposure was also considered in view of the patient’s pediatric age. The examination provided visualization of contrast-medium distribution in the proximal and distal colon and information regarding the colonic condition in the observed case.

ABSTRAK

Pemeriksaan lopografi pada pasien pediatrik dengan klinis post-colostomy Hirschsprung dilakukan untuk memperoleh gambaran anatomi kolon dan distribusi media kontras sebagai dasar evaluasi kondisi pasien sebelum penatalaksanaan lanjutan. Penelitian ini bertujuan mendeskripsikan prosedur pemeriksaan lopografi serta alasan tidak dilakukannya foto post-evacuation pada pasien pediatrik dengan klinis post-colostomy Hirschsprung. Penelitian menggunakan metode kualitatif deskriptif dengan pendekatan studi kasus yang dilaksanakan di Instalasi Radiologi RSD K.R.M.T. Wongsonegoro Semarang pada September 2025–Mei 2026. Data dikumpulkan melalui observasi, wawancara, dokumentasi, dan studi kepustakaan dengan melibatkan tiga radiografer dan satu dokter spesialis radiologi. Hasil penelitian menunjukkan bahwa persiapan pasien meliputi verifikasi data, pembersihan area stoma, pelepasan kantong stoma, penggantian pakaian, dan pengisian informed consent. Media kontras yang digunakan berupa iodin water-soluble dan NaCl dengan perbandingan 1:4, sedangkan teknik pencitraan meliputi proyeksi AP polos, AP post-contrast, dan lateral. Foto post-evacuation tidak dilakukan karena media kontras bersifat water-soluble, dapat keluar dari tubuh, serta mempertimbangkan pembatasan paparan radiasi pada pasien pediatrik. Pemeriksaan tersebut menghasilkan gambaran distribusi media kontras pada kolon proksimal dan distal serta informasi mengenai kondisi kolon pada kasus yang diteliti.