Ascending colon cancer and situs inversus totalis: a case report in Sanglah general hospital Denpasar, Bali

Situs inversus totalis is a rare congenital condition that occurs in one out of 4,000-20,000 people, characterized by complete transposition of the thoracic and abdominal viscera that creates a mirror image. The etiologic nature of this anomaly is not known. Situs inversus totalis is typically associated with normal life expectancy unless a gastrointestinal or cardiac anomaly is present. This anomaly is not a premalignant condition. Association between colorectal cancer and situs inversus totalis is rare. The transposition of the organs imposes special demands on the diagnostic and technical skills of the surgeon. We report a case of colorectal cancer and situs inversus totalis in a 51-year-old male presenting with intermittent left lower abdominal pain and change of bowel habit since 9 months before admission. We found a palpable solid mass on the left paraumbilical region, mobile, with no tenderness. Laboratory results show moderate anemia with high CEA level. Fecal Occult Blood Test (FOBT) was positive. Plain chest radiography showed suspected situs inversus. We found descending colon tumor on colonoscopy, with histopathology result intramucosal carcinoma. The contrast abdomen CT scan showed situs inversus and irregular thickening on ascending colon with partial stenosis. We performed extended left hemicolectomy and intraoperative we found a mass in the hepatic flexure of the colon with no sign of lymph node and liver metastases. The histopathologic diagnosis was adenocarcinoma moderately differentiated. The patient was diagnosed with adenocarcinoma of ascending colon T3N0M0, stage II

Faktor Risiko Terjadinya Batu Empedu di RSUP Dr. Wahidin Sudirohusodo Makassar

Tujuan: untuk mengetahui apakah terdapat hubungan beberapa faktor seperti jenis kelamin, usia, diabetes, obesitas, dan hiperlipidemia, sebagai penyebab munculnya batu empedu di RSUP Dr. Wahidin Sudirohusodo. Metode: penelitian ini dilakukan dengan pengambilan sampel secara retrospektif pada pasien yang dirawat diruang bedah di Rumah Sakit Wahidin Sudirohusodo Makassar bulan Januari sampai dengan Desember 2013, sampel diambil secara konsekutif berurutan sebesar jumlah sampel yang dibutuhkan. Hasil: sampel yang masuk kriteria inklusi dari penelitian ini sebanyak 196 orang.  Dari 196 orang 114 (58,5%) orang dengan batu empedu, 101 perempuan (51,5%) dan 95 laki-laki (48,5%). Terdapat 86 (75,4%) penderita dengan batu empedu yang berusia di bawah 40 tahun dan 28 (24,6%) penderita berusia lebih dari 40 tahun. Berdasarkan jenis kelamin 26 (22,8%) penderita laki-laki dengan batu empedu dan 88 (77,2%) perempuan dengan batu empedu. Penderita DM dengan batu empedu sebanyak 103 (90,4%), pasien dengan obesitasyang menderita batu empedu sejumlah 97 (85,1%), 88 (77,2%) penderita dengan kadar trigliserida yang meningkat dengan batu empedu, dan 95 (83,3 %) pasien dengan kadar kolesterol yang meningkat mengalami batu empedu. Simpulan: jenis kelamin perempuan, usia di bawah 40 tahun, penderita diabetes, obesitas dan hiperlipidemia merupakan faktor risiko menimbulkan batu empedu

Profile of Abdominal Trauma Patient Underwent Surgery in Emergency Operating Room of Sanglah General Hospital from January until December 2015

Objective: to investigate the characteristics of patients, presentation of the abdominal organ that involved, and clinical data associated with this event. Methods: this is a descriptive study with retrospective design. Total samples were all patients with abdominal trauma who underwent surgery on the emergency operating theatre of Sanglah General Hospital between January and December 2015. Baseline data of patients were obtained from the medical records. Results: within the study period, a total of 104 patients with abdominal trauma who underwent surgery in the emergency operating room of Sanglah General Hospital were identified. Man comprised 87.5% of the patients and mostly were 17-45 years old (75%). The motor vehicle accident occurred majority on the weekend (65%). Liver and spleen were the most affected organ (55%). Splenectomy (35%) and liver repair surgery (33%) were the most often performed procedures. Conclusion: Abdominal trauma caused by motor vehicle accident occurred mostly on the weekend. Two most affected organs in abdominal trauma were liver and spleen. Splenectomy and liver repair surgery were the procedures performed for these trauma patients

Blunt abdominal trauma in Sanglah Hospital Bali, Indonesia: a study of 65 cases

Abdominal trauma is a challenge for every surgeon, whether related to diagnosis or treatment. In developing countries, the number of traumatic events associated with death makes it necessary for a study to be carried out to see the patterns and damage caused by abdominal trauma and the organs involved. Material and Method is all patients with blunt trauma of the abdomen who came to emergency unit Sanglah Hospital Bali, from January 2017 up to May 2018 that undergo laparotomy exploration were enrolled, the data were collected retrospectively using patient medical records. Results is 65 patients with blunt abdominal trauma came to the emergency department and undergoes laparotomy exploration, range of age was 4-74 year old and 75.3% of them were men. The most common injured organs were spleen and liver, both are 26 and 15 cases (40 and 23%). Another intraoperative finding are Ileum Perforation (10 cases) Left Zone II Retroperitoneal Haematoma (7 cases), and Mesenterium Rupture (5 cases). Splenectomy was the most performed procedure (26 cases). The most common cause of blunt abdominal trauma was motor vehicle accident. Hypovolemic shock was the most common clinical presentation (48 patient). The Conclusions are according to this study, men consisted 75.3% cases of blunt abdominal trauma and the range age of patients was 4-74 year old. The most common cause was motor vehicle accident. Among patients with intra-abdominal organ damage, spleen and liver were most commonly involved. About 84.6% of all patients with blunt abdominal trauma were discharged without complication and morbidity