Current Diagnostic Approach of Inflammmatory Bowel Disease

Inflammatory bowel disease (IBD) has begun to emerge in Indonesia. The disease is further classifiedinto two types, ulcerative colitis (UC) and Crohn\u27s disease (CD). Diagnosis of IBD is initiated from symptomfindings such as diarrhea, abdominal pain, bleeding diarrhea, and weight loss, and supported by physicalexamination and additional tests. The options for additional examinations of IBD are mainly endoscopy (esophagogastroduodenoscopy, colonoscopy, and also intestinal endoscopy), imaging techniques, and laboratory examinations either from blood or feces. The application of these modalities should be prompted by sufficientclinical suspicion to promote their efficiency as well as prevent underdiagnosis or overdiagnosis. In primaryhealth care settings, patients with IBD are expected to be recognized for therapy or to use appropriate referralsystem to warrant a proper treatment

Mirizzi's Syndrome

Mirizzi's syndrome was an obstruction caused by gallstone located in gallbladder neck (or cystic duct) or outside gallbladder that caused a dilatation of gallbladder and narrowing of adjacent duct, sometimes with the presence of cholecystocholedochal fistula. Mirizzi's syndrome was a rare complication of gallbladder stone. We reported a 42 years old woman complained progressive icteric sclera. Patients also complained dark urine and light stool. During physical examination, we found an icteric sclera, pain in right upper quadrant (visual analogue scale/VAS 3), and generalized icterus (greenish yellow). Complete examination revealed a Mirizzi's syndrome