Trauma Ginjal-Referat Radiologi

7/23/2019 Trauma Ginjal-Referat Radiologi

http://slidepdf.com/reader/full/trauma-ginjal-referat-radiologi 1/23

DAFTAR ISI

DAFTAR ISI...........................................................................................................1

TINJAUAN PUSTAKA..........................................................................................2

DEFINISI......................................................................................................2

EPIDEMIOLOGI..........................................................................................2

ETIOLOGI....................................................................................................2

PATOFISISOLOGI........................................................................................3

PATOMEKANISME.....................................................................................4

KLASIFIKASI TRAUMA GINJAL.............................................................5

GEJALA KLINIS..........................................................................................7

DIAGNOSIS.................................................................................................7

DIAGNOSIS RADIOLOGI..........................................................................8

PEMERIKSAAN RADIOLOGI..................................................................10

KESIMPULAN............................................................................................21

DAFTAR PUSTAKA.............................................................................................22

1



TINJAUAN PUSTAKA

I. Definisi

Trauma !"#a$ a%a$a& '(%(ra )a%a !"#a$ *a" %!+(,a,-a" $(& ,(r,aa! ma'am /rauma ,a!-

/um)u$ mau)u" /a#am.

II. Epidemiologi

Trauma !"#a$ m(ru)a-a" /rauma *a" )a$!" +(r!" /(r#a%! %! ,a!a" /ra-/u+ ur("!/a$ 10

III. Etiologi

A%a 3 )("*(,a, u/ama %ar! /rauma !"#a$ *a!/u

1.Trauma /a#am

2.Trauma Ia/r("!-

3.Trauma /um)u$

Trauma /a#am +()(r/! /(m,a-a" %a" /!-ama" m(ru)a-a" 10 20 )("*(,a, /rauma

)a%a !"#a$ %! I"%"(+!a. 6a!- $u-a /!-am a/au /u+u- )a%a a,%m(" ,a!a" a/a+ a/au )!"a"

mau)u" $u-a /(m,a- )a%a a,%m(" *a" %!+(r/a! &(ma/ur!a m(ru)a-a" /a"%a )a+/! '(%(ra )a%a

!"#a$.

Trauma !a/r("!- )a%a !"#a$ %a)a/ %!+(,a,-a" $(& /!"%a-a" )(ra+! a/au ra%!$!

!"/(r("+! %!ma"a %! %a$am"*a /(rma+u- r(/rra%( )*($ra)&* )(r'u/a"(u+ "()&r+/m*

%a" )(r'u/a"(u+ $!/&/r!)+*. D("a" +(ma-!" m("!"-a/"*a ))u$ar!/a+ %ar! /(-"!- /(-"!- %!

a/a+ !"+!%("+ /rauma !a/r("!- +(ma-!" m("!"-a/. T(/a)! -(mu%!a" m("uru" +(/($a&

%!)(r-("a$-a" ESL. 6!)+! !"#a$ #ua %a)a/ m("*(,a,-a" /rauma !"#a$.

Trauma /um)u$ m(ru)a-a" )("*(,a, u/ama %ar! /rauma !"#a$. D("a" $a#u"*a

)(m,a"u"a" )("am,a&a" rua+ #a$a" %a" #um$a& -("%araa" -(#a%!a" /rauma a-!,a/

-('($a-aa" $a$u $!"/a+ #ua +(ma-!" m("!"-a/.

Trauma /um)u$ !"#a$ %a)a/ ,(r+!9a/ $a"+u" mau)u" /!%a- $a"+u". Trauma

$a"+u" ,!a+a"*a %!+(,a,-a" $(& -('($a-aa" $a$u $!"/a+ $a& raa -(r#a a/au

)(r-($a&!a". Trauma !"#a$ ,!a+a"*a m("*(r/a! /rauma ,(ra/ *a" #ua m("("a! ra":ra"

2



$a!". Trauma /!%a- $a"+u" m!+a$"*a #a/u& %ar! -(/!"!a" *a" m("*(,a,-a" )(r(ra-a"

!"#a$ +('ara /!,a /!,a %! %a$am r"a )(r!/"(um. K(#a%!a" !"! %a)a/ m("*(,a,-a" au$+!

)(%!-($ !"#a$ a/au r,(-a" /u"!-a !"/!ma ar/(r! r("a$!+ *a" m("!m,u$-a" /rm,+!+.

A%a ,(,(ra)a 9a-/r *a" /uru/ m("*(,(,-a" /(r#a%!"*a /rauma !"#a$. G!"#a$ *a" r($a/!9

m,!$( %a)a/ ,(r(ra- m("("a! '+/a( a/au 'r)u+ (r/(,ra( ,a!- -ar("a /rauma $a"+u"

a/au)u" /!%a- $a"+u" a-!,a/ %(+($(ra+!. K(%ua /rauma *a" %(m!-!a" %a)a/ m("*(,a,-a"

)("!"-a/a" /(-a"a" +u,'r/!'a$ %a" !"/ra'a$!'(a$ *a" '()a/ +(&!"a m("a-!,a/-a" /(r#a%!"*a

ru)/ur. ;a" -(/!a a%a$a& -(a%aa" )a/$!+ %ar! !"#a$ !/u +("%!r!.

S(,aa! /am,a&a" #!-a ,a+( $!"( %ar! /(-a"a" !"/ra)($!+ m("!"-a/ ma-a -("a!-a"

+(%!-!/ +a#a %ar! /(-a"a" /(r+(,u/ +u%a& %a)a/ m("*(,a,-a" /(r#a%!"*a /rauma !"#a$. <a$ !"!

m("#($a+-a" m("a)a )a%a )a+!(" *a" *a" m(m!$!-! -($a!"a" )a%a !"#a$"*a mu%a& /(r#a%!

/rauma !"#a$.

IV. Patofisiologi Trauma in!al

Trauma !"#a$ /um)u$ %!-$a+!9!-a+!-a" +(+ua! -()ara&a" $u-a %a" *a" )a$!" +(r!"

%!/(mu-a" a%a$a& -"/u+! !"#a$. Trauma /um)u$ )a%a r(!" '+/a -( 12 m("(-a" !"#a$ -(

$um,ar +)!"( %a" a-a" m("a-!,a/-a" '(%(ra )a%a )!"a" a/au ,a!a" ,a=a& !"#a$. D!/(m)a/

'+/a 12 m(m,(r! !m)a-.

G!"#a$ #ua %a)a/ ru+a- a-!,a/ %ar! /(-a"a" %ar! ,a!a" a"/(r!r a,%m(" +(r!" -a$!

%a$am -('(%(raa" %a$am -('($a-aa" $a$u $!"/a+. Trauma )("(/ra+! *a" +(r!" -a$! %!+(,a,-a"

$(& $u-a /u+u- a/au $u-a /(m,a- +(r!" %!/(mu-a" #ua. a$au)u" +(r!" %!/(mu-a" &(ma/ma

)(r!:r("a$ )a+!(" mu"-!" /!%a- m("u"#u--a" &(ma/ur!a -('ua$! $u-a m("'a)a! 'a$*> a/au

)($!+.

Trauma !"#a$ %a)a/ /(r#a%! $(& -ar("a ,(raam m(-a"!+m(. K('($a-aa" m/r m(ru)a-a" )("*(,a, /(r,a"*a- %ar! /rauma /um)u$ a,%m!"a$ *a" m("*(,a,-a" /rauma !"#a$.

S($a!" !/u #a/u& %ar! -(/!"!a" $u-a /(m,a- m(ru)a-a" )("*(,a, $a!"""*a.Pa%a -a+u+ #ara"

/rauma !"#a$ /(r#a%! $(& -ar("a )("*(,a, !a/r("!' *a" %a)a/ ,(rma"!9(+/a+! %("a"

)(r%ara&a" +(/($a& /rauma m!"r.

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S(,a!a" ,(+ar /rauma ru)/ur !"#a$ mu"'u$ %("a" (#a$a &(ma/ur!a ?5 *a" %a)a/

m("#a%! ,(+ar )a%a ,(,(ra)a /rauma !"#a$ *a" ,(ra/. A-a" /(/a)! /rauma a+-u$(r

ur(/(r)($!' UPJ &(ma/ur!a -(mu"-!"a" /!%a- /am)a-.O$(& -ar("a +(,a!a" ,(+ar

)("a"a"a" /rauma /(rma+u- /rauma !"#a$ m(m,u/u&-a" +(%!-!/ )r+(%ur !"a+!9 ma-a

)(m(r!-+aa" ra%!$! +a"a/$a& )("/!".D("a" )(m(r!-+aa" *a" a-ura/ %ar! ra%!$! )a+!("

%a)a/ %!/a"a"! %("a" )/!ma$ +('ara -"+(ra/!9 %ar! )("a"a"a" )(m,(%a&a".

V. PAT"#EKANIS#E

G"'a"a" !"#a$ %! %a$am r"a r(/r)(r!/"(um

r(a"a" )(%!-($ !"#a$

m("!m,u$-a" r,(-a" /u"!-a !"/!ma ar/(r!r("a$!+.

/(r,("/u-"*a ,(-ua":,(-ua" %ara& &(ma/m

m("!m,u$-a" /rm,+!+ ar/(r! r("a$!+ ,(+(r/a 'a,a":'a,a""*a.

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VI. Klasifi$asi Trauma in!al

6(r%a+ar-a" American Association for the surgery of Trauma %AAST& /rauma !"#a$

/(r,a! %a$am ,(,(ra)a %(ra#a/

Tu#ua" )("-$a+!9!-a+!a" /rauma !"#a$ a%a$a& u"/u- m(m,(r!-a" )(%ma" %a$am m("("/u-a"

/(ra)! %a" )r"+!+.

rade I

K"/u+! !"#a$/(r%a)a/ )(r%ara&a" %! !"#a$ /a")a a%a"*a -(ru+a-a" #ar!"a"-(ma/!a" #ar!"a"

mau)u" -(ru+a-a" -a$!-+. <(ma/ur!a %a)a/ m!-r+-)!- a/au ma-r+-)!-.)("'!/raa" "rma$.

rade II

<(ma/m +u,-a)+u$ar a/au )(r!"(a$ *a" /!%a- m($ua+ /a")a a%a"*a -($a!"a" )ar("-!m.

rade III

La+(ra+! !"#a$ @ 1 'm %a" /!%a- m("("a! )($!-a$!-+ %a" /!%a- /(r#a%! (-+/raa+a+!.

5



rade IV

La+(ra+! 1'm %a" /!%a- m("("a! )($!-a$!-+ a/au (-+/raa+a+! ur!". La+(ra+! *a" m("("a!

-r/(-+m(%u$$a %a" )($!-a$!-+

rade V

B(%(ra )(m,u$u& %ara& u/ama au$+! )(m,u$u& %ara& *a" m("a-!,a/-a" a"ua"

)(r%ara&a" !"#a$ $a+(ra+! $ua+ )a%a ,(,(ra)a /(m)a/C !"#a$ *a" /(r,($a&.

VII. e!ala Klinis

Pa%a /rauma /um)u$ %a)a/ %!/(mu-a" a%a"*a #(#a+

%! %a(ra& $um,a$ +(%a"-a" )a%a /rauma /a#am /am)a- $u-a.

6



Pa%a )a$)a+! %!%a)a/-a" "*(r! /(-a" %a(ra& $um,a$ -(/(a"a" // )!"a"

+(%a"-a" ma++a #ara" /(ra,a. Ma++a *a" '()a/ m("*(,ar $ua+ %!+(r/a! /a"%a

-(&!$a"a" %ara& m(ru)a-a" )(/u"#u- a%a"*a '(%(ra a+-u$(r. N*(r! a,%m(" umum*a %!/(mu-a" %! %a(ra& )!"a" a/au )(ru/ ,a!a" a/a+

%("a" !"/("!/a+ "*(r! *a" ,(rar!a+!. 6!$a %!+(r/a! '(%(ra &()ar a/au $!m)a

%!/(mu-a" a%a"*a /a"%a )(r%ara&a" %a$am )(ru/. 6!$a /(r#a! '(%(ra Tr. D!(+/!u+

%!/(mu-a" a%a"*a /a"%a ra"+a" )(r!/"(um. Fra-/ur '+/a( /(r,a=a& +(r!" m("*(r/a! '(%(ra !"#a$. 6!$a &a$ !"! %!/(mu-a"

+(,a!-"*a %!)(r&a/!-a" -(a%aa" )aru a)a-a& /(r%a)a/ &(ma//&ra-+ a/au

)"(um/&ra-+ <(ma/ur!a ma-r+-)!- m(ru)a-a" /a"%a u/ama '(%(ra +a$ura" -(m!&. D(ra#a/

&(ma/ur!a /!%a- ,(r,a"%!" %("a" /!"-a/ -(ru+a-a" !"#a$. P(r$u %!)(r&a/!-a"

,!$a /!%a- a%a &(ma/u/!a -(mu"-!"a" '(%(ra ,(ra/ +()(r/! )u/u+"*a )(%!-($ %ar!

!"#a$ a/au ur(/(r %ar! )($!+ !"#a$. Pa%a )(m(r!-+aa" 9!+!- %a)a/ %!/(mu-a" /a"%a

+&'-.

VIII. Diagnosis

K('ur!aa" /(r&a%a) a%a"*a '(%(ra !"#a$ #!-a /(r%a)a/

1. Trauma %! %a(ra& )!"a" )u"u" %a%a +(,($a& ,a=a& %a" )(ru/ ,a!a" a/a+

%("a" %!+(r/a! "*(r! a/au %!%a)a/-a" a%a"*a #(#a+ )a%a %a(ra& !/u.

2. <(ma/ur!a.

3. Fra-/ur '+/a +(,($a& ,a=a& T8:T12 a/au 9ra-/ur )r+(+u+ +)!"+u+ (r/(,ra.

4. Trauma /(m,u+ )a%a %a(ra& a,%m(" a/au )!"a".

5. B(%(ra %(+($(ra+! *a" ,(ra/ a-!,a/ #a/u& %ar! -(/!"!a" a/au -('($a-aa" $a$u $!"/a+.

Gam,ara" -$!"!+ *a" %!/u"#u--a" $(& )a+!(" /rauma !"#a$ +a"a/ ,(rar!a+! /(ra"/u"

)a%a %(ra#a/ /rauma %a" a%a a/au /!%a-"*a /rauma )a%a ra" $a!" *a" m("*(r/a!"*a. P(r$u

%!/a"*a-a" m(-a"!+m( '(%(ra u"/u- m(m)(r-!ra-a" $ua+ -(ru+a-a" *a" /(r#a%!.

Pa%a /rauma %(ra#a/ r!"a" mu"-!" &a"*a %!%a)a/-a" "*(r! %! %a(ra& )!"a" /(r$!&a/

#(#a+ ,(ru)a (-!m+!+ %a" /(r%a)a/ &(ma/ur!a ma-r+-)!- a/au)u" m!-r+-)!-. Pa%a /rauma

ma*r a/au ru)/ur )(%!-($ +(r!"-a$! )a+!(" %a/!" %a$am -(a%aa" +*- ,(ra/ %a" /(r%a)a/

&(ma/m %! %a(ra& )!"a" *a" ma-!" $ama ma-!" m(m,(+ar. Da$am -(a%aa" !"! mu"-!"

7



)a+!(" /!%a- +(m)a/ m("#a$a"! )(m(r!-+aa" IP -ar("a u+a&a u"/u- m(m)(r,a!-! &(m%!"am!-

+(r!"-a$! /!%a- m(m,ua&-a" &a+!$ a-!,a/ )(r%ara&a" *a" -($uar %ar! !"#a$ 'u-u) %(ra+. U"/u-

!/u )(r$u +((ra %!$a-u-a" (-+)$ra+! $a)ar/m! u"/u- m("&("/!-a" )(r%ara&a".

I'. Diagnosti$ Radiologi

A%a ,(,(ra)a /u#ua" )(m(r!-+aa" ra%!$!+ )a%a )a+!(" *a" %!'ur!a! m("%(r!/a /rauma

!"#a$ *a!/u

1. K$a+!9!-a+! ,(ra/"*a /rauma +(&!"a %a)a/ %!$a-u-a" )("("a"a" *a" /()a/ %a"

m("("/u-a" )r"+!+"*a

2. M("*!"-!r-a" -(a%aa" !"#a$ )a/$!+ )r( /rauma

3. M("(a$ua+! -(a%aa" !"#a$ -"/ra$a/(ra$

4. M("(a$ua+! -(a%aa" ra" !"/ra a,%m(" $a!""*a

Pa%a )(m(r!-+aa" ra%!$!+ %a)a/ %!/(mu-a"

rade I

• K"/u+! %a)a/ /(r$!&a/ +(,aa! ma++a *a" "rma$ a/au)u" /!%a-

• La+(ra+! m!"r -r/(-+ !"#a$ %a)a/ %!-("a$! +(,aa! %9(- $!"(ar )a%a )ar("-!m a/au

/(r$!&a/ m!r!) %("a" -"/u+! !"#a$

•

;a" $(,!& )("/!" )("'!/raa" IP )a%a )a+!(" /rauma !"#a$ ra%( I %a)a/ m("u"#u--a"am,ara" !"#a$ "rma$. <a$ !"! /!%a- /(r$a$u m("!m,u$-a" ma+a$a& -ar("a )("%(r!/a

ra%( I m(ma" /!%a- m(m(r$u-a" /!"%a-a" )(ra+! .

• Pa%a BT S'a" %a(ra& *a" m("a$am! -"/u+! /(r$!&a/ +()(r/! ma++a 'a!ra" %!a"/ara

)ar("-!m !"#a$

rade II

• Pa%a IP %a)a/ /(r$!&a/ (>/raa+a+! -"/ra+ %ar! %a(ra& *a" m("a$am! $a+(ra+!

• E>/raa+a+! /(r+(,u/ ,!+a &a"*a /(r,a/a+ )a%a +!"u+ r("a$!+ a/au m($ua+ +am)a! -( %a(ra&

)(r!"(9r" a/au ,a&-a" +am)a! -( a"/(r!r a/au )+/(r!r )ara"(9r".

• ;a" -&a+ a%a$a& ,a/a+ $uar !"#a$ /(r$!&a/ -a,ur a/au $(,!& $(,ar.

• D("a" )(m(r!-+aa" BT S'a" 9ra-/ur )ar("-!m !"#a$ %a)a/ /(r$!&a/+

8



• A-umu$a+! ma+!9 %ar! -"/ra+ /(ru/ama )a%a m(%!a$ %a(ra& )(r!"(9r" %("a"

)ar("-!m !"#a$ *a" ma+!& !"/a- %a" ""!+ua$!(% ur(/(r m(ru)a-a" %ua" -ua/

/(r#a%!"*a au$+! ur(/(r)($!' #u"'/!"

rade III

• S('ara -$!"!+ )a+!(" %a$am -a%aa" *a" /!%a- +/a,!$. K%a" -a%a" %a)a/ /(r#a%! +&'-

%a" +(r!" /(ra,a ma++a )a%a %a(ra& 9$a"-.%a)/ %!(r/a! %("a" &(ma/ur!a.

• 6!$a )a+!(" +u%a& 'u-u) +/a,!$ %a)a/ %!$a-u-a" )(m(r!-+aa" IP %!ma"a /(r$!&a/

a"ua" 9u"+! (-+-r(+! ,a!- )ar+!a$ mau)u" //a$

• A%a 2 /!)( $(+! )a%a )($!+ r("a$!+ *a!/u /rm,+!+ A.R("a$!+ %a" au$+! A. R("a$!+.

A"!ra9! %a)a/ m(m)(r$!&/-a" am,ara" -$u+! A.R("a$!+.

• !a,!$!/a+ %ar! 9ram(" !"#a$ %a)a/ %!$!&a/ +('ara a"!ra9!. Ar/(r!ra9!

m(m)(r$!&a/-a" 2 9ram(" !"#a$ *a" /(r)!+a& 'u-u) #au&.9ram(" *a" !a,($ a-a"

/(r$!&a/ &m(" -ar("a ma+!& m("%a)a/ )(r9u+! 'u-u) ,a!-. Fram(" %!a"/ara"*a

,(rar/! m(ru)a-a 9ram(" *a" +u%a& /!%a- !a,$( $a!.

rade IV

• Gra%( I m($!)u/! au$+! %ar! ur(/(r)($!' #u"'/!".

• 6a!- IP mau)u" BT S'a" m(m()(r$!&a/-a" a%a"*a a-umu$a+! -"/ra+ )a%a %(ra&

)(r!"(9r" /a")a )("!+!a" ur(/(r.

S(,aa! -(+!m)u$a" +am)a! +(-ara" ,($um a%a )(m,a/a+a" *a" #($a+ -a)a" +(ra"

)("%(r!/a *a" %!%ua /rauma !"#a$ m(m(r$u-a" IP a/au BT S'a" +(,aa! )(m(r!-+aa"

)("u"#a""*a. K()u/u+a" /(r+(,u/ &aru+ %!%a+ar-a" -()a%a )(m(r!-+aa" ma"a-a& *a" $(,!&

/(r+(%!a.

BT Sa" ,!a+a"*a %!am,!$ +(,aa! )(m(r!-+aa" )("u"#a" )(r/ama )a%a )+!(" *a" m("a$am!

/rauma mu$/!)$( ra" !"/ra a,%m(" %a" )a+!(" *a" %!%ua /rauma !"#a$ Gra%( III a/au I.

BT S'a" ,(r9u"+! +(,aa! )(m(r!-+aa" -(%ua +(/($a& IP )a%a )a+!(" *a" )a%a IP

m(m)(r$!&/-a" am,ara" -(ru+a-a" $ua+ )ar("-!m !"#a$ %a" )a+!(" *a" -(a%aa" umum"*a

m("uru".

'. Pemeri$saan Radiologi pada Trauma in!al

1. F/ P$+ A,%m("

9



A%a"*a ,$!/(ra+! )+a+ +&a%= m("u"#u--a" &(ma/m r(/r)(r!/"(aa$ a/au

(-+/raa+a+! ur!". U%ara u+u+ )!"%a& %ar! )+!+!"*a. Pa%a /u$a" /am)a- 9ra-/ur

)r+(+u+ /ra"+(r+a$!+ (r/(,ra a/au 9ra-/ur !a.D"a" 1??4

am(ar ) T(r$!&a/ am,ar ra%!ra9! ru)/ur( !"#a$ +)"/a". P+a+ $!"( -!r! /(r$!&a/ "rma$

)a"a& &!/am )+a+ $!"( -a"a" /!%a- /(r$!&a/ )a"a& m(ra&.

2. P!($ra9! !"/ra("a IP

D!$a-u-a" #!-a %!%ua a%a 1 $u-a /u+u- a/au $u-a /(m,a- *a" m("("a! !"#a$

2 '(%(ra /um)u$ !"#a$ *a" m(m,(r!-a" /a"%a:/a"%a &(ma/ur!a ma-r+-)!- %a"

3 '(%(ra /um)u$ !"#a$ *a" m(m,(r!-a" /a"%a:/a"%a &(ma/ur!a m!-r+-)!- %("a"

%!+(r/a! +*-

10



Gam,ara" *a" /(r$!&a/ a%a$a& )(m,("-a-a" )a%a !"#a$ -"/ra+ *a" (-+/raa+a+!

-($uar /am)a-a" ma++a )(r%ara&a" #ua ,!+a /(r$!&a/ +(r/a /am)a- -($a!"a" (-+-r(+! #!-a

%!,a"%!"-a" %("a" !"#a$ +(,($a&.

am(ar *+, IP %!am,!$ )a%a m("!/ -( 15 %a" 45 /(r$!&a/ (-+/raa+a+! m($ua+ %!

)(r!)($!+ %a" )(r!r("a$.

11



am(ar - Pa%a )a+!(" Trauma !"#a$ IP 10 m("!/ !"#a$ %a" ur(/(r ma+!& /(r$!&a/

"rma$.

3. USGPa%a )(m(r!-+aa" USG D))$(r a-a" /(r$!&a/ +()(r/! +(m,ura" =a/(r #(/ )a%a ,a!a"

+!+! !"#a$ *a" ru)/ur -(/!-a a%a +(%!-!/ -m)r(+! $(& ur!"ma.

A 6 B

am(ar A/ P("am)a-a" ru)/ur( !"#a$ +)"/a". 0/ m("u"#u--a"

%(9(- ,(r%!am(/(r 45mm 1/ a%a$a& )("am)a-a" USG D))$(r ,(r=ar"a /(r$!&a/

a$!ra"=ar"a )a%a !"#a$ *a" ,(r&u,u"a" %("a" -m)r(+! $(& ur!"ma

am(ar 2 Pa%a )(m(r!-+aa" USG )a%a a"a- umur 8 /a&u"%("a" -a+u+ )a+'a /rauma

!"#a$ ra%( 4 /(r#a%! aa+-u$ar *a" $ua+ )a%a ,a!a" ,a=a& !"#a$ +(&!"a /(r#a%!"*a

!"9ar- %! -(%ua !"#a$"*a .

12



4. BT:SBAN S/a!" /rauma !"#a$ )a$!" a-ura/ %!$a-u-a" %("a" +ara"a BT +'a". T(-"!-

""!"a+! !"! +('ara #($a+ m(m)(r$!&a/-a" $a+(ra+! )ar("-!m %a" (-+/raa+a+! ur!"

m("(/a&u! !"9ar- )ar("-!m +(m("/a$ m("(/a&u! u-ura" %a" $-a+! &(ma/m

r(/r)(r!/"(a$ !%("/!9!-a+! #ar!"a" ""!a,$( +(r/a '(%(ra /(r&a%a) ra" +(-!/ar

+()(r/! $!(" &()ar )a"-r(a+ %a" -$" G((&a" 2003. M%a$!/a+ *a" )a$!" ,a!- u"/u- m($!&a/ am,ara" ru)/ur !"#a$ -ar("a !"9rma+!

*a" %!,(r!-a" ,(r-a!/a"%("a" mr9$! %a" 9u"+!"a$ !"#a$ ,!+a %!%a)a/-a"

%a$am +a/u -a$! )(m(r!-+aa" +a#a. Da)a/ m("u"#u--a" a%a"*a r,(-a" #ar!"a" !"#a$ (-+/raa+a+!-"/ra+ *a" $ua+

%a" a%a"*a "(-r+!+ #ar!"a" !"#a$ +(r/a m("%(/(-+! a%a"*a /rauma )a%a ra" $a!".

am(ar 3 / Trauma !"#a$ %("a" rade ). T(r$!&a/ Gam,ar %ar! BT +'a" -"/ra+ *a"

%!/!"-a/-a" %ar! )(ru/ )a%a )a+!(" %("a" &(ma/ur!a +(/($a& /a,ra-a" -("%araa" ,(rm/r

m("u"#u--a" /(r%a)a/ %a(ra& *a" /!%a- #($a+ %ar! &*)("&a"'(m("/ %! !"#a$ -a"a" m(%!a$.

13



am(ar 4 / Trauma !"#a$ rade ) %("a" &(ma/ma +u,-a)+u$ar . BT +'a" a,%m(" %("a"

-"/ra+ !"/ra("a )a%a )a+!(" +(/($a& /a,ra-a" -("%araa" ,(rm/r m("u"#u--a" am,ara"

+()(r/! ,u$a" +a,!/ %("a" &!&:%("+!/* %a" /(r%a)a/ 'a!ra" %! +(-!/ar !"#a$ -!r! . Ba/a/a" mar!"

$uar *a" #($a+ %a" %(9rm!/a+ r!"a" %ar! )ar("-!m !"#a$ .

14



am(ar 5 / Trauma !"#a$ rade * %("a" $a+(ra+! !"#a$ . Gam,ara" BT +'a" A,%m("

+(/($a& /a,ra-a" -("%araa" ,(rm/r m("u"#u--a" %a"-a$ -ura" %ar! 1 'm )ar("-!m !"#a$

'a'a/ %("a" &(ma/ma )(r!"(9r!- ,(+ar .

am(ar )6 / Trauma !"#a$ rade , $a+(ra+! !"#a$ . BT +'a" a,%m(" +(/($a& )(m,(r!a"

-"/ra+ !"/ra("a m("u"#u--a" /!%a- /(ra/ur ""("&a"'!" )ar("-!m !"#a$ 'a'a/ %("a"

(-+/("+! $(,!& ,(+ar %ar! 1 'm %a$am %a" %(-a/ %("a" )($!+ !"#a$ .

15



am(ar )) /Trauma !"#a$ rade - '(%(ra !"#a$ +(m("/a$ !"9ar- . Gam,ara" BT +'a"

a,%m(" ,a!a" a/a+ m("u"#u--a" ar(a +(m("/a$ %ar! ""("&a"'(m("/ %! !"#a$ -!r! m(%!a$

a/a+ /a")a /(r-a!/ $a+(ra+! !"#a$.

am(ar )* /Trauma !"#a$ rade -7 '(%(ra !"#a$ . Tam)a- La+(ra+! m(m)(r$ua+ -(

'$$('/!" +*+/(m !"#a$. Gam,ara" BT +'a" a,%m(" )a%a )a+!(" %("a" &(ma/ur!a +(/($a&

/a,ra-a" -("%araa" ,(rm/r m("u"#u--a" r,(-a" %a$am m(m)(r$ua+ -( %a$am '$$('/!"

16



+*+/(m !"#a$ -a"a" %a" /(r#a%! (-+/("+! -( %a$am '$$('/!" +*+/(m %a" %!,u-/!-a" $(&

(-+/raa+a+! -"/ra+ -(m!& )a%a am,ar *a" /(r/u"%a m($a$u! !"#a$ %a$am 9a+( (-+-r(+! .

am(ar ), /Trauma !"#a$ rade '(%(ra !"#a$ S&a//(r(% !"#a$ . Gam,ara" BT +'a"

a,%m(" )a%a )a+!(" %("a" &(ma/ur!a %a" &!)/("+! +(/($a& /a,ra-a" -("%araa" ,(rm/r

m("u"#u--a" /ra"+(-+! %ar! !"#a$ -a"a" %("a" &(ma/ma ,(+ar +(-!/ar %a" a"/ara 2 ,a!a"

!"#a$ . 2 ,a!a" -(%ua"*a )(r9u+! -ar("a a%a 2 ar/(r! !"#a$.

5. Magnetic Resonance Imaging %#RI&

MRI %!u"a-a" u"/u- m(m,a"/u )("a"a"a" /rauma !"#a$ -(/!-a /(r%a)a/

-"/ra!"%!-a+! u"/u- )("u"aa" -"/ra+ !%!"a/(% a/au -(/!-a )(m(r!-+aa" BT:S'a" /!%a-

/(r+(%!a. S()(r/! )a%a )(m(r!-+aa" BT MRI m("u"a-a" -"/a+ Ga%$!"!um !"/ra("a *a"

%a)a/ m(m,a"/u )("a"a"a" (-+/raa+a+! +!+/(m ur!"ar!u+. P(m(r!-+aa" !"! m(ru)a-a"

)(m(r!-+a" /(r,a!- %("a" +!+/(m $a)a"a" )a"%a" *a" $ua+.

'I. Kompli$asi

17



Km)$!-a+! a=a$ P(r%ara&a" *a" ma+! +a"a/ +(r!" /(r#a%! /(ru/ama %!

r(/r)(r!/"(a$. P(r+!+/(" r(/r)(r!/"(a$ )(r+!+/(" a/au r++ &(ma/ur! *a" ,(ra/ !"%!-a+! u"/u-

%!$a-u-a" )(ra+!.

Km)$!-a+! $a"#u/ &*)(r/("+! &*%r"()&r+!+ ar/(r!("u+ 9!+/u$a )(m,("/u-a"

'a$'u$u+ %a" )*($"()&r!/!+. r("a$ a/r)&* %a)a/ mu"'u$ %ar! a+'u$ar 'm)rm!+( %a" %a)a/

%!%!/(-+! %("a" urra)&*. P(r%ara&a" *a" ,(ra/ %a" $a"#u/ %a)a/ mu"'u$ +(/($a& 1:4 m!"u.

'II. Penatala$sanaan

Pa%a +(/!a) /rauma /a#am *a" %!%ua m("("a! !"#a$ &aru+ %!)!-!r-a" u"/u- m($a-u-a"

/!"%a-a" (-+)$ra+! /(/a)! )a%a /rauma /um)u$ +(,a!a" ,(+ar /!%a- m(m(r$u-a" )(ra+!. T(ra)!

)a%a /rauma !"#a$ a%a$a&

1. K"+(ra/!9

T!"%a-a" -"+(ra/!9 %!/u#u-a" )a%a /rauma m!"r. D!$a-u-a" ,+(ra+! /a"%a:

/a"%a !/a$ m($!)u/! !+/!ra&a/ %! /(m)a/ /!%ur a"a$(+!- u"/u- m("&!$a"-a" "*(r! +(r/a

,+(ra+! +/a/u+ !"#a$ %("a" )(m(r!-+aa" -"%!+! $-a$ -a%ar &(m$,!" &(ma/-r!/

+(r/a +(%!m(" ur!".

-(mu"-!"a" a%a"*a )("am,a&a" ma++a %! )!"a" a%a"*a

)(m,(+ara" $!"-ara" )(ru/ )("uru"a" -a%ar &a(m$,!" %ara& %a" )(ru,a&a" =ar"a

ur!"(.

J!-a +($ama /!"%a-a" -"+(ra/!9 /(r%a)a/ /a"%a:/a"%a )(r%ara&a" a/au -(,'ra"

ur!"( *a" m("!m,u$-a" !"9(-+! &aru+ +((ra %!$a-u-a" /!"%a-a" )(ra+!.

a. E-+)$r+!

a. I"%!-a+! a,+$u/(

I"%!-a+! a,+$u/ a%a$a& a%a"*a )(r%ara&a" !"#a$ )(r+!+/(" *a" %!/a"%a! $(&

a%a"*a &(ma/m r(/r)(r!/"(a$ *a" m($ua+ %a" ,(r%("*u/. Ta"%a $a!" a%a$a&a%a"*a au$+! a+a r("a$!+ u/ama )a%a )(m(r!-+aa" BT +'a" a/au ar/(r!ra9!.

,. I"%!-a+! r($a/!(

H Jar!"a" ""!a,$(

Par("-!m !"#a$ *a" "(-r+!+ $(,!& %ar! 25 a%a$a& !"%!-a+! r($a/!9 u"/u-

%!$a-u-a" (-+)$ra+!.

18



H E-+/raa+a+! ur!"

E-+/raa+a+! ur!" m("a"%a-a" a%a"*a '(%(ra !"#a$ ma*r. 6!$a (-+/raa+a+!

m("(/a) ma-a m(m,u/u&-a" !"/(r("+! ,(%a&.

H I"'m)$(/( +/a!"

P("a/a$a-+a"aa" "")(ra/!9 %!mu"-!"-a" a)a,!$a /($a& %!$a-u-a" )(m(r!-+aa"

!ma!" u"/u- m("!$a! %(ra#a/ /rauma !"#a$. A%a"*a !"'m)$(/( +/a!"

m(m(r$u-a" )(m(r!-+aa" !ma!" %a&u$u a/au (-+)$ra+! Cr(-"+/ru-+! !"#a$.

Pa%a )a+!(" %("a" -"%!+! /!%a- +/a,!$ *a" m(m(r$u-a" /!"%a-a" $a)ar/m!

+((ra )(m(r!-+aa" !ma!" *a" ,!+a %!$a-u-a" &a"*a$a& "( +&/ IU %! m(#a

)(ra+!. 6!$a &a+!$ IU a,"rma$ a/au /!%a- #($a+ a/au a%a"*a )(r%ara&a" )(r+!+/("

)a%a !"#a$ &aru+ %!$a-u-a" (-+)$ra+! !"#a$.

H Trm,+!+ Ar/(r!

B(%(ra %(+($(ra+! ma*r m("*(,a,-a" r(a"a" )a%a ar/(r! r("a$!+ %a" a-a"

m("*,(- /u"!-a !"/!ma /(r#a%! /rm,+!+ ar/(r! r("a$!+ u/ama a/au 'a,a"

+(m("/a$"*a *a" a-a" m("*(,(,-a" !"9ar- )ar("-!m !"#a$. P("(a-a"

%!a"+!+ *a" /()a/ +(r/a /!m!" )(ra+! +a"a/ )("/!" %a$am )("*($ama/a"

!"#a$. R("a$ +a$a( %!mu"-!"-a" a)a,!$a !+-(m!a -ura" %ar! 12 #am. J!-a

!"#a$ -"/ra$a/(ra$ "rma$ a%a -"/r(r+! a)a-a& )(r$u r(a+-u$ar!+a+! a/au

,+(ra+!.J!-a !+-(m!a m($(,!&! 12 #am !"#a$ a-a" m("a$am! a/r9!. N(9r(-/m!

%!$a-u-a" &a"*a ,!$a %($a*(% '($!/m* %!$a-u-a" -ar("a a%a"*a '(%(ra ra"

$a!" a/au #!-a &!)(/("+! m("(/a) )a+'a )(ra+!. Trm,+!+ ar/(r! r("a$!+ ,!$a/(ra$

-m)$!/ a/au a%a"*a !"#a$ +$!/(r %!,u/u&-a" (-+)$ra+! +((ra %a"

r(a+-u$ar!+a+!.

H Trauma /(m,u+

Pa%a /rauma /(m,u+ !"%!-a+! a,+$u/ %!$a-u-a" (-+)$ra+! a%a$a& )(r%ara&a"

ar/(r! )(r+!+/(". <am)!r +(mua /rauma /(m,u+ r("a$ %!$a-u-a" /!"%a-a" ,(%a&.

P(r-('ua$!a" a%a$a& /rauma !"#a$ /a")a a%a"*a )("(/ra+! )($uru !"/ra)(r!/"(um

Lu-a /u+u- +(,($a& )+/(r!r $!"(a a-+!$ar!+ )+/(r!r r($a/!9 /!%a- m($!,a/-a"

'(%(ra ra" $a!".6ra"%(+ 2003

3. O)(ra+!

19



O)(ra+! %!/u#u-a" )a%a /rauma !"#a$ ma*r %("a" /u#ua" u"/u- +((ra

m("&("/!-a" )(r%ara&a". I"%!-a+! (-+)$ra+! !"#a$ *a!/u +*- *a" /!%a- /(ra/a+! %a"

+*- ,(ru$a". S($a"#u/"*a )(r$u %!$a-u-a" %(,r!%(m("/ r()ara+! !"#a$ a/au /!%a- #ara"

&aru+ %!$a-u-a" "(9r(-/m! )ar+!a$ ,a&-a" "(9r(-/m! //a$ -ar("a -(ru+a-a" !"#a$ *a"

+a"a/ ,(ra/.

Kesimpulan

20



G!"#a$ +a"a/ /(r$!"%u"! $(& ra":ra" %!+(-!/ar"*a +(&!"a %!)(r$u-a" -(-ua/a"

*a" 'u-u) *a" ,!+a m("!m,u$-a" '(%(ra !"#a$. Namu" )a%a -"%!+! )a/$!+ +()(r/!

&!%r"(9r+!+ a/au ma$!"a"+! !"#a$ ma-a !"#a$ mu%a& ru)/ur $(& &a"*a /rauma r!"a".

M,!$!/a+ !"#a$ +("%!r! m(m,a=a -"+(-u("+! /(r#a%!"*a '(%(ra )ar("-!m a/au)u" a+-u$(r.

S(,a!a" ,(+ar /rauma !"#a$ a%a$a& /rauma /um)u$ %a" +(,a!a" ,(+ar /rauma /um)u$

m("!m,u$-a" '(%(ra m!"r )a%a !"#a$ *a" &a"*a m(m,u/u&-a" ,(% r(+/.

D!a"+!+ /rauma !"#a$ %!/(a--a" %("a" a"am"(+!+ )(m(r!-+aa" 9!+!- %a" )("u"#a". Pa%a

)(m(r!-+aa" 9!+!- %!a$! m(-a"!+m( /rauma +(r/a -(mu"-!"a" a*a *a" m("!m)a !"#a$

mau)u" ra" $a!" %!+(-!/ar"*a. P(m(r!-+aa" 9!+!- %!)(r$u-a" u"/u- m("!$a! A6B "*a /rauma

$-a$ !"#a$ mau)u" ra" $a!" *a" /(r$!,a/. Pa%a )a+!(" mu"-!" %!/(mu-a" &(ma/ur!a r++

a/au)u" m!-r+-)!+ a/au mu"-!" /a")a &(ma/ur!a. 6!$a -"%!+! /!%a- +/a,!$ =a$au %("a"

r(+u+!/a+! ma-a /!%a- a%a )!$!&a" -('ua$! (-+)$ra+! +((ra . Pa%a )(m(r!-+aa" )("u"#a" )$a!"

)&/ ,!+a %!/(mu-a" )a/a& /u$a" !a ,a=a& )r+(+u+ /ra"+(r+u+ (r/(,ra $um,a$ *a"

m("u"#u--a" -('ur!aa" -!/a /(r&a%a) /rauma !"#a$. Pa%a )(m(r!-+aa" IP a-ura+!"*a ?0

"amu" )a%a )a+!(" &!)/("+! /!%a- ,!+a %!&ara)-a" &a+!$"*a. Pa%a -"%!+! /a- +/a,!$ ma-a &a"*a

%!$a-u-a" "( +&/ IP *a" ,!+a m("!$a! !"#a$ -"/ra$a/(ra$. P(m(r!-+aa" %("a" BT +'a"

m(ru)a-a" $% +/a"%ar% -ar("a %("a" a$a/ !"! ,!+a m($a-u-a" ra%!" %("a" ,a!-. 6a!a":

,a!a" !"9ar- !"#a$ /(r$!&a/ +(r/a +($uru& ra" a,%m(" +(r/a r(/r)(r!/"(um #ua #($a+.

P(m(r!-+aa" a"!ra9! +a"a/ ,a!- %!$a-u-a" )a%a -('ur!aa" '(%(ra a+-u$(r. D!$a-u-a"

ar/(r!ra9! a)a,!$a BT +'a" /!%a- /(r+(%!a. K(ru!a""*a )(m(r!-+aa" !"! !"a+!9.

Pr!"+!) )("a"a"a" /rauma !"#a$ a%a$a& m(m!"!ma$!+a+! mr,!%!/a+ %a" mr/a$!/a+ +(r/a +(%a)a/

mu"-!" m(m)(r/a&a"-a" 9u"+! !"#a$. <a"*a )a+!(" %("a" !"%!-a+! #($a+ %!$a-u-a"

"(9r(-/m!. T(-"!- )(ra+! +aa/ !"! m(m(a" )(ra"a" )("/!" %a$am )("*($ama/a" !"#a$.

D("a" -"/r$ )(m,u$u& %ara& !"#a$ ma-a /(r#a%! )("uru"a" a"-a "(9r(-/m!. K"/r$

)(m,u$u& %ara& %!$a-u-a" %!$uar 9a+!a G(r/a +(,($um ma+u- "a /rauma. Ta")a !+$a+! ar/(r!

%a" ("a %(-m)r(+! &(ma/m !"#a$ *a" %!$a-u-a" %ura"/( )(ra+! m("!"-a/-a" !"+!%("+!

"(9r(-/m!.

DAFTAR PUSTAKA

21



1. 6a(r+/'- R S!m"+ R M'Lu&$!" M. S((r( ,$u"/ r("a$ /rauma a 7:*(ar

r(/r+)('/!( r(!(= 9rm a )r!"'!a$ /rauma '("/r(. Can J Urol . 2001 O'/. 851372:

. M(%$!"(.

2. Saa$=+-* AI M'B""($$ JD P(/(r+ PB. R("a$ /rauma r(u!r!" +ur(r* a" a"a$*+!+ 9

185 'a+(+. J Trauma. 1?83 F(,. 232128:31. M(%$!"(.

3. L(( ;J O& SN R&a SE 6*u" J;. R("a$ /rauma. Radiol Clin North Am. 2007 Ma*.

453581:?2 !>.M(%$!"(.

4. Sa"/u''! RA (++($$+ < 6ar/+'& G D(+'/(+ J <(*"+ BF M'A"!"'& J (/ a$.Ea$ua/!" a"% ma"a(m("/ 9 r("a$ !"#ur!(+ '"+("+u+ +/a/(m("/ 9 /&( r("a$ /rauma

+u,'mm!//((. BJU Int . 2004 Ma*. ?37?37:54. M(%$!"(.

5. 6("/ B I*"-ara" T P=(r N Ma/+" M <a#%!"#a- T 6u'&&$ N (/ a$. Ur$!'a$

!"#ur!(+ 9$$=!" /rauma. Clin Radiol . 2008 D('. 312131:71. M(%$!"(.

. <ar%(( MJ L=ra"'( S/(("+ M< N!ru$a R 6ra"/ O Mrr!+ SE (/ a$. Pr'(++!m)r(m("/ !" /rauma 'm)$!a"'( =!/& r('mm("%(% !ma!" (a$ua/!" !" /&(

%!a"+!+ 9 &!&:ra%( r("a$ !"#ur!(+. J Trauma Acute Care Surg . 2013 F(,. 742558:

2. M(%$!"(.

7. 6ar/$(* JM Sa"/u''! RA. Bm)u/(% /mra)&* 9!"%!"+ !" )a/!("/+ =!/& )(%!a/r!' ,$u"/r("a$ /rauma !" =&m (>)('/a"/ "")(ra/!( ma"a(m("/ 9a!$(%. Urology. 2012 D('.

801338:43. M(%$!"(.

8. L!" B L!" B< B&(" J< B&(" ;F B&a" B< u SB (/ a$. Bm)u/(% /mra)&!'

!ma!" !" %(/(rm!"!" /&( "((% 9 (m,$!a/!" 9r &!&:ra%( ,$u"/ r("a$ !"#ur*. JTrauma Acute Care Surg . 2013 Ja". 741230:5. M(%$!"(.

?. u R L! ;K L! T a" SS ;ua" G &u F (/ a$. R(a$:/!m( 3:%!m("+!"a$

'"/ra+/:("&a"'(% u$/ra+u"% !" %(/('/!" &(mrr&a( 9 ,$u"/ r("a$ /rauma. Am J Emerg

Med . 2013 O'/. 31101427:1431.M(%$!"(.

10. P(r(:6ra*9!($% MR Ga//! JM Sm!/& EA. 6$u"/ /rauma/!' &(ma/ur!a !" '&!$%r(". I+ a+!m)$!9!(% a$r!/&m #u+/!9!(%. J Urol . 2002 Ju". 172543: %!+'u++!" 254:

7. M(%$!"(.

11. Mra" DE Na$$ama$a LK K(""(* PJ. BT '*+/ra)&* ra%!ra)&!' a"% '$!"!'a$

)r(%!'/r+ 9 ,$a%%(r ru)/ur(. AJR Am J Roentgenol . 2000 Ja". 17418?:?5. M(%$!"(.

12. &//)CC===.+'!("'("(=+.rCar/!'$(+C200 ? 010C9%.a+)

13. &//)CC===.m(%+'a)(.'mC!(=ar/!'$(C57048?+r'Qm)"(=+

14. Ru'&($$( J. L 6($$%ru" A 6ru"!'ar%! F.B. Ur$* !" 6ru"!'ar%! F.B (/ a$ E%!/r.

S'&=ar/+ Pr!"'!)$(+ 9 Sur(r*. ?/& (%. M'Gra=:<!$$.N(= ;r-. 2010. )145?:1475.15. Sa"/u''! R.A Duma"!a" L.R U))(r Ur!"ar* Tra'/ Trauma !" Bam,($$:a+&. 10/& (%.

E$+(!(r. N(= ;r-. 2012. P1172:11?1

22

http://reference.medscape.com/medline/abstract/11718633

















http://www.sciencenews.org/articles/20090106/food.asp

http://www.medscape.com/viewarticle/570489?src=mpnews











http://www.sciencenews.org/articles/20090106/food.asp

http://www.medscape.com/viewarticle/570489?src=mpnews




1. Summ(r/m D.J (/ a$$. R("a$ Trauma !" Gu!%($!"(+ " Ur$!'a$ Trauma. Eur)(a"

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Trauma Ginjal-Referat Radiologi

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