Kolelitiasis sering dijumpai dalam praktek sehari-hari. Selain kolik bilier, kolelitiasis juga dapat menunjukkan gejala atipik berupa dispepsia, sehingga dapat menyebabkan kesalahan diagnosis. Laporan kasus ini bertujuan untuk menjelaskan pentingnya evaluasi sindrom dispepsia dengan diagnosis akhir kolelitiasis. Seorang wanita berusia 33 tahun dirawat dengan keluhan nyeri epigastrik. Pasien didiagnosis dispepsia, namun terapi penghambat pompa proton tidak menghasilkan perbaikan. Pada pemeriksaan fisik ditemukan demam, sklera ikterik, dan nyeri tekan abdomen kuadran kanan atas. Pemeriksaan laboratorium menunjukkan neutrofilia dan hiperbilirubinemia. Pada ultrasonografi (USG) abdomen, ditemukan batu kandung empedu, batu duktus sistikus, dan kolesistitis. Pemeriksaan magnetic resonance cholangiopancreatography (MRCP) menunjukkan adanya batu duktus koledokus. Intervensi berupa endoscopic retrograde cholangiopancreatography (ERCP) disertai ekstraksi batu dan kolesistektomi laparoskopik memperbaiki keluhan nyeri perut. Kolelitiasis perlu dipertimbangkan sebagai diagnosis banding keluhan dispepsia.   Cholelithiasis is often encountered in daily practice. Besides biliary colic, cholelithiasis may show atypical manifestations as dyspepsia. This may lead to misdiagnosis and inappropriate therapy. This case report reemphasized the importance of careful evaluation of dyspepsia. A 33-year-old woman was admitted with epigastric pain. She was diagnosed with dyspepsia, but proton pump inhibitor (PPI) did not result in any improvement. On physical examination, fever, icteric sclera, and right upper quadrant abdominal tenderness were found. Laboratory examination showed neutrophilia and hyperbilirubinemia. An abdominal ultrasound (USG) examination revealed gallbladder stones, cystic duct stones, and cholecystitis. Magnetic resonance cholangiopancreatography (MRCP) examination revealed the presence of stone in the common bile duct. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction and laparoscopic cholecystectomy. After the procedure, the abdominal pain improved. Cholelithiasis should be considered a differential diagnosis of dyspepsia.

Background: Hypovitaminosis D is highly prevalent in chronic kidney disease (CKD). This conditionmay increase CKD progression and cause various complications, since kidney has a pivotal role in metabolizing the vitamin D. The aim of this study was to find the difference in vitamin D levels among CKD stage 3 to 5. Methods: A cross-sectional study involving patients aged over 18 years with CKD stage 3 to 5 who visited Dr.

Hiponatremia didefinisikan sebagai kadar natrium serum <135 mEq/L. Hiponatremia sering dijumpai, tetapi etiologinya sulit dipastikan. Seorang laki-laki berusia 64 tahun datang dengan keluhan lemas sejak beberapa hari. Pada pemeriksaan laboratorium ditemukan hiponatremia, hipoosmolalitas serum, peningkatan ekskresi natrium urin, serta peningkatan osmolalitas urin; sesuai dengan karakteristik syndrome of inappropriate antidiuretic hormone (SIADH). Pemeriksaan hormonal serum dan MRI kepala menemukan prolaktinoma dan penurunan kortisol serum yang menandakan kondisi insufisiensi adrenal. Terapi infus NaCl dan kapsul NaCl serta hydrocortisone berhasil memperbaiki keadaan pasien, baik secara klinis maupun laboratorium.   Hyponatremia is defined as a serum sodium level of <135 mEq/L. Hyponatremia is a common finding but its etiology is often difffcult to be determined. A 64-year-old male came with lethargy since a few days before being admitted to the hospital. Laboratory examination revealed hyponatremia, serum hypoosmolality, increased urinary sodium excretion, and increased urine osmolality, are in accordance with the characteristics of syndrome of inappropriate antidiuretic hormone (SIADH). Serum hormonal examination and head MRI revealed a prolactinoma and decreased serum cortisol which indicated an adrenal insufficiency. NaCl infusion and oral NaCl supplementation, and hydrocortisone improved patient’s clinical condition and laboratory findings.