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DR. dr. HM. Alsen Arlan Sp.B.

KBD MARS
Curiculum Vitae

DR. dr. H.M. Alsen Arlan, Sp.B KBD., MARS

Tempat / Tgl lahir : Palembang, 4 Juni 1962


Nip / Pangkat. Gol : 196206041989031005/Pembina Utama Muda IV.c
Alamat Rumah : Komplek Taman Istana Blok A 3 – 4, Jln. Lingkar Istana, Demang
Lebar Daun, Palembang.

No. Telp : HP. 0811785284

Status Kawin
Istri : Dr. Hj. Desty Aryani M.Kes
Anak : 1. dr. Apriandini Mirdasari Putri, dr. M Hafidh Komar, SpB KBD
 2. dr. M.Arisma Dwirian Putra
Pendidikan

 S1 Dokter FK UNSRI Palembang, Lulus tahun 1988.

 Spesialis Bedah Bag. Bedah FK UNSRI /RS MH Palembang,


Lulus tahun 2000.
 Sub Spesialis Bedah Digestive Konsultan Bag. Bedah FK UNPAD
RS. Hasan Sadikin Bandung, Brevet tahun, 2004
S3. (Doktor) ; Program Pascasarjana UNPAD, Bandung
Bidang Studi Ilmu Kedokteran.Lulus 8 Mei 2008
Program Studi Magister Administrasi Rumah Sakit
Program Pasca Sarjana Universitas Respati Indonesia Jakarta 2013

Diklat PIM II SPIMNAS, Lembaga Administrasi Negara Jakarta,


21 Februari – 1 Mei 2012.
Pekerjaan
RSUD Baturaja OKU 1989 – 1990
Puskesmas Kemalaraja, Baturaja OKU, 1990-1992
Puskesmas Martapura OKU, 1992 – 1995.
PPDS I Ilmu bedah FK Unsri/RSMH Palembang, 1995 – 2000
Staff Bag. Bedah FK Unsri / RSMH Palembang. 2000 – 2002.
Bandung,
Trainee Konsultan Bedah Digestive, Bgn Bedah Digestive RS. Hasan Sadikin
2002 – 2004.
Palembang,
Staff. Sub Bagian Bedah Digestive, Bag. Bedah FK Unsri / RS. Moh. Hoesin
2004 – Sekarang.
2010
Kepala Instalasi Bedah Sentral, Rumah Sakit Muhammad Hoesin Palembang. 2008 –

Juni
Direktur Umum, SDM & Pendidikan RSUP Dr. Mohammad Hoesin Palembang.
2010 sd. 20 September 2013
23

Direktur Medik dan Keperawatan 20 september 2013 sd –sekarang.


Penghargaan

Indonesia
Satyalancana Karya Satya 20 Tahun dari Presiden Republik

Tri Windu Bakti Karya Husada 24 tahun, Kementerian Kesehatan RI


Adhiaksa Utama Pengabdian IDI
Negara
Penghargaan Terbaik Diklat PIM II SPIMNAS, Lembaga Administrasi
Jakarta 21 Februari – 1 Mei 2012.
Tips and Trics
Blunt Abdominal Trauma
DR. Dr. H.M. Alsen Arlan, SpB-KBD,MARS
Bedah Digestive
Departemen Bedah – FK Unsri / RSUP Mohammad Hoesin
Palembang - 2018
8

Abdominal Trauma:
Penetrating (23,8%) > Blunt (12,1%)
Morbidity & mortality due to bleeding and/or
visceral perforation resulting in sepsis
Single or multiple concomitant organ injuries:
Triad of death : coagulopathy, acidosis, & hypothermia
Sabiston, Text Book of Surgery,2017
9

 Abdominal Trauma
 Early resuscitation (Damage Control Resuscitation) & rapid
assessment and control sources of bleeding and/or
contamination (Damage Control Surgery or Definitive
Surgery)
 Retained foreign bodies traversing abdominal wall must be
maintained & protected from excessive movement during
initial evaluation
Classification Of Abdominal Trauma

 Penetrating
High velocity (85% penetrate peritoneum)
Low velocity (95% need surgery)
Stab (1/3 do not penetrate the peritoneum, of those
50% need Surgery)
 Blunt trauma
High energy transfer (car accident)
Low energy transfer (fall, fight)

Mattox 2013, in Trauma 7th ed


Spleen 40% to 55%
Liver 35% to 45%
Small Bowel 5% to 10%
Retroperitoneal 15 %

Advanced Trauma Life Support 10th


Sabiston, Text Book of Surgery,2017
Algorithm for the initial evaluation of a patient with suspected blunt abdominal trauma. CT = computed
tomography; DPA = diagnostic peritoneal aspiration; FAST = focused abdominal sonography for trauma; Hct =
hematocrit

Schwartz’s 2015, Principles of Surgery 10th Edition.


Advanced Trauma Life Support 10th ed
Damage Control
Damage limitation surgery
• Goal ->
1. STOP any active surgical bleeding
2. Control contamination

Bailey and Love’s 2008, Short Practice of Surgery 25th ed


Bailey and Love’s 2008, Short Practice of Surgery 25th ed
17

TACD - VAC Bedside Laparotomy- ICU

PIN IKABDI 12/8/2017

Mattox 2013, in Trauma 7th ed


Mattox 2013, in Trauma 7th ed
19

Sabiston, Text Book of Surgery,2017


Mattox 2013, in Trauma 7th ed
21

R. Shayn Martin, J. Wayne Meredith,Sabiston,


Text Book of Surgery,2017
FIGURE 30-6
Mattox 2013, in Trauma 7th ed Algorithm for the diagnosis and management of splenic injury
Mattox 2013, in Trauma 7th ed
Mattox 2013, in Trauma 7th ed
1. Rido Kamulyan / ♂ / 18 YO Admition : 24 -11-17 06.30 WIB

ANAMNESIS
Pain On His Abdomen After Trafic Accident
± 3,5 Hour before admition his motorcycle had sliped, he fall with
His abdomen hit by the hard thing.

SURVEY PRIMER
A. Good
B. RR : 20 x/mnt
C. BP : 100/ 70 mmHg
Pulse : 83 x/mnt
Temp : 36.4° C
D. GCS : E4M6V5 : 15 Pupil was Isochor,
Light reflexes +/+
SECONDARY SURVEY

Thorax :
I : Excoriation at left clavicule 2 x 3,5 cm in size
P : Pain (-), Crepitation (-)
P : Sonor on Both Hemithorax
A : Vesiculer on Both Hemithorax

Abdomen
I : FLat, Bruised (+)
P : Soft, Muskular Rigidity (-)
P : Tympani
A : Bowel Sound (+)

DRE : Blood (-), feses (+)


NGT : Blood (-)
RADIOLOGI
Ro Thorax
Fracture (-), Hemopneumothorax (-)
RADIOLOGI
FAST
Fluid Collection (+)
LABORATORIUM
Hb : 12.8 gr/dl (12-16 gr/dl)
Ht : 37 vol % ( 40-48vol%)

DIAGNOSE
Abdominal blunt injury Without Peritonitis + Spleenic Injury
Grade II

PENATALAKSANAAN
 02 nasal canule 3L/m
 IVFD RL gtt xx /m
 NGT + Uretral Catheter
 Observation
 CT Scan
 USG
RADIOLOGI
CT Scan abdomen kontras tgl 24-11-17
Spleenic injury grade II
Follow-up at 12.00 AM (6 hour after admition)
S : Pain On Whole Abdomen
O : Sens : CM
RR : 24x/mnt
HR : 118
BP : 100/60mmHg
Temp : 36.4
Abdomen
I : FLat, Bruised (+)
P : Soft, Muskular Rigidity (-)
P : Tympani
A : Bowel Sound (+)
USG : Massive Fluid Collection
A : Abdominal blunt injury Without Peritonitis + Spleen Injury
Grade II
P : Laparatomy exploration
INTRA OPERATION
In Cavum abdomen we found blood and blood clot ± 2000cc
We performed packing 4 big gauze
In Further Exploration we found laseration of spleen± 4cm with
irreguler edge
We Performed splenoraphy  Bleeding was Stoped
1. Irsan bin Irfan/♂ / 6 tahun MRS : 21-08-2017
PKL : 15.34 WIB

ANAMNESIS
Nyeri Perut
± 1 jam smrs,motor yang ditumpangi penderita jatuh bertabrakan
dengan mobil dari arah belakang. Penderita terjatuh dengan perut
membentur benda keras
(Rujukan YK Madira)

SURVEY PRIMER
A. Baik
B. RR : 24 x/mnt
C. N : 110 x/mnt
T : 36,6° C
D. GCS : E4M6V5= 15 Pupil Isokhor, RC +/+
SURVEY SEKUNDER

Regio Thorax
I: jejas (-)
P: sonor kedua hemithorax
A: Vesikuler kedua hemithorax

Regio Abdomen
I: jejas (+)
P: defans muskular (-)
P: Tympani
A: BU (+) normal

Regio Flank Sinistra


I: Jejas (+)
P: nyeri tekan (-)

RT: ampula tidak kolaps, darah (-)


RADIOLOGI
FAST
Cairan Bebas (-)
LABORATORIUM
Hb : 12,5 gr/dl (12-16 gr/dl)
Ht : 38 vol % ( 40-48vol%)
URINALISA
Lekosit sedimen (routine) : 0-1 (0-5)
Eritrosit sedimen (routine) : 0-1 (0-1)

DIAGNOSA
Trauma tumpul abdomen tanpa tanda-tanda peritonitis
PENATALAKSANAAN
 Observasi

Pasien rawat bangsal


Jacobs 2010, Advanced Trauma Operative Management 2nd ed
TERIMAKASIH