Digestive and General

Effect of bioabsorbable (fibrillar) and fibrin glue on the number of macrophages

and fibroblasts in Wistar rats with gastric perforation compared to the omental
patch method

Background: Gastric perforation covers 25-30% of acute abdomen in the ER and has
high mortality and morbidity rate (Buck, 2012). WHO said that deaths from gastric
perforation in Indonesia reached 0.99 percent which was obtained from the death rate
of 8.41 over 100,000 citizens (WHO, 2011). Surgery is the main treatment of gastric
perforation. The Omental patch commonly used to close the gastric perforation.
Exploration laparotomy and omental patch remain the gold standard. As an alternative
to omental patch, it has been thought of how to close the perforation without injuring
the edges of the perforation so that it does not pose a risk of leakage. One method is
bioabsorbable material that is glued with fibrin glue. The main problem is to found
the treatment of gastric perforation, which is looking for an efficient and safe
therapeutic approach. This study was conducted to determine the effect of
bioabsorbable material as a seamless technique in healing gastric perforation wounds.
Methods: This study was true laboratory experimental post test only control group
design single blind in rat. The aim of the study was to determine the effect of
bioabsorbable (fibrillar) and fibrin glue material on the number of macrophages and
fibroblasts in wistar rats with gastric perforation compared to the omental patch
method. The treatment group was divided into 2 randomly groups. 20 rats were
divided into fibrillar and fibrin glue groups, and omental patch groups.

Results: A calculation was made in both groups, the average number of fibroblasts
produced by the fibrillar and fibrin glue group was 7.5 and the number of fibroblasts
produced by the omental patch group was 5.4. This shows that the average number of
fibroblasts produced by the fibrillar and fibrin glue group is higher than the number of
fibroblasts produced by the omental patch group. In this T test (fibroblasts) there was
a significance value of 0,001 so that the significance value was smaller than alpha 5%
(0,001 <0,050) indicating that there were significant differences (H1 accepted) on the
number of fibroblasts produced using fibrillar and fibrin glue over the omental
method patch. From the calculation of macrophage cells obtained, an average number
of fibrillar and fibrin glue groups of macrophages is 4 and the omental patch group is
3. To see if there are any differences in the average sample T-test independent test. In
this T test (macrophage) obtained a significance value of 0.004 so the significance
value is smaller than alpha 5% (0.004 <0.050). This shows that there is a significant
difference (H1 is accepted) on the amount of macrophage produced using fibrillar and
fibrin glue over the omental patch method.

Conclusion: From the study, it was concluded that the administration of fibrillar and
fibrin biomaterials in the closure of gastric perforation increased the number of
macrophage and fibroblast cells better that the omental patch method, in other way the
closure of gastric perforations with fibrillar and fibrin glue biomaterials had the
potential to be an alternative therapy for gastric perforation.

Keywords: Bioabsorbable, Fibrin glue, Macrophages, Fibroblasts, Omental Patch

Comparison of a number of fibroblast and collagen density scores in ileum
anastomosis with basting stitches and interrupted stitch technique (study on
Rabbit New Zealand)

Adith Fileanugraha1, Vicky Sumarki Budipramana2, Ariandi Setiawan2

1Resident of General Surgery Program Airlangga University Medical Faculty/Dr.
Soetomo General Hospital, Surabaya

2Teaching staff of General Surgery Department of Airlangga University Medical

Faculty/Dr. Soetomo General Hospital, Surabaya

Background: Intestinal anastomosis manually is carried out with the technique of

continuous and simple interrupted sutures. Simple interrupted suture is now standard
in intestinal anastomosis. Continuous suture has the advantage of better serosal
apposition, and shorter processing time and triggers the formation of hypoxia
inducible factor which can stimulate the production of VEGF and PDGF that
stimulate migration and proliferation of mesenchymal cells, especially fibroblast cells
which support the synthesis and increasing collagen density in anastomosis tissue. To
compare the anastomosis technique with continuous and simple interrupted sutures
reviewed from fibroblast count and collagen density score in rabbit intestines.

Methods: This study is an experimental study. The sample of this study consisted of
36 rabbits divided into 2 groups continuous and simple interrupted sutures.
Randomization is done by permuted randomization block. The inclusion criteria in
this study were Rabbits strain oryctolagus cuniculus aged 8-9 months, weighing 2000-
2500 grams, healthy and active. The independent variable in this study is the ileal
anastomosis technique and the dependent variable is the number of fibroblasts and the
collagen density score formed on the anastomosis tissue assessed histopathologically
(PA)

Results: In the results of this study was found that the average age of rabit was 8
months, with an average weight of 2400 grams, the group of rabbits which received
continuous suture a number of fibroblasts was 10 fibroblasts / visual field with
collagen score was 3, whereas in rabbits getting interrupted stitch sutures a number of
fibroblasts is 8 fibroblasts / visual field with collagen score is 2. However the results
of analytic testing, showed that rabbits treated with continuous suture showed that
were not significantly different in fibroblast count and collagen density score
compared to simple interrupted group (p>

ABSTRACT

0.05), but in continuous rabbit group have higher collagen density scores and number
of fibroblasts than rabbits who get simple interrupted suture Conclusion: This study
proves that there is no significant difference between intestinal anastomoses in rabbits
get continuous suture compared to those treated with simple interrupted sutures.

Keywords: intestinal anastomosis, continuous suture, simple interrupted sutures,

fibroblasts, collagen
The use of transanastomotic tube in surgical management of congenital duodenal
obstruction of the newborn: case series

Hadrian Gunardi1, Asri D Rachmawati2, Riana P Tamba3 1Surgery resident in

Faculty of Medicine, University of Indonesia; Cipto Mangunkusumo General
Hospital, Jakarta, Indonesia2Staff of Pediatric Surgery Division, Fatmawati General
Hospital, Jakarta, Indonesia

3Staff of Pediatric Surgery Division, Cipto Mangunkusumo General Hospital, Jakarta,

Indonesia

Backgrounds: Prolonged starvation is a significant concern in post-operative

management of congenital duodenal obstruction. Massive dilatation of proximal
segment would lead to caliber discrepancy and hypomotility, thus delaying enteral
feeding. Transanastomotic tube is an option to deliver early enteral feeding after
surgical correction. Study aims to evaluate the effectiveness and the safety of
transanastomotic tube in surgical management of congenital duodenal obstruction.

Methods: We collected cases of congenital duodenal obstruction of the newborn that

is surgically corrected and managed with transanastomotic tube from January 2016
until December 2018 at Cipto Mangunkusumo General Hospital and Fatmawati
General Hospital.

Result: Ten cases were collected, with the mean of gestational age of 30.4 weeks (SD
± 2.12), with mean of body weight of 2.571 g (SD ± 392). Seventy percents of the
cases accompanied by other anomalies. Enteral nutrition was introduced immediately
after surgery. The median time of initiation of oral nutrition was 13 days (3-21), and
the patients were adequately fed in 19.5 days (13-37). The average length of stay was
24.5 days (16-40 days). One case had a complication requiring surgery. Mortality
happened in 2 cases due to sepsis. Conclusion: Transanastomotic tube is an option to
deliver early enteral feeding after surgical correction of congenital duodenal
obstruction.

Keywords: congenital duodenal obstruction, transanastomotic tube, early enteral

feeding, case series
Case reportGallstone ileus due to cholecystogastric fistula: a brief report and
review literature

Agung Kurniawan, Samuel Sampetoding

Digestive Surgery Division, Departement of Surgery, Medical Faculty of Hasanuddin

University, Makassar, Indonesia 2019

Backgroud: Gallstone ileus is a rare complication of cholelithiasis accounting for

1%-4% of defined as intestinal obstruction due to impaction of one or more gallstones
within the gastrointestinal tract. Cholecystogastric fistula itself is a rare fistulous tract
formation, which one it results from the gradual erosion of the approximated and
chronically inflamed wall of the gall bladder and stomach.

Case Description: A 39-year-old female with gallstone ileus due to cholecystogastric

fistula, which we manage with one stage procedure (enterolithotomy,
cholecystectomy and fistula closure) and patient discharged on day 10 with good
condition.

Conclusion: This case report has highlighted that gallstone ileus is a rare case.
Computed tomography has proven to be the most accurate diagnostic modality. And
the best treatment for patients with good general condition and adequately stabilized
preoperative is onestage surgical procedure (cholecystectomy and repair of fistula)

Key Word: Gallstone Ileus, Cholecystogastric Fistula, One Stage Procedure

Endoscopic retrograde cholangiopancreatography in Surgery Department of
Prof. Dr. R. D. Kandou General Hospital: 2 years experiencesHEPATOBILIER

Tampubolon H1, Mambu T2, Tjandra F21Resident in Surgery, Surgery

Departement, Sam Ratulangi University School of Medicine, Manado, Indonesia
2Division of Digestive Surgery, Surgery Departement, Sam Ratulangi University
School of Medicine, Manado, Indonesia

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a

technique that combines the use of endoscopy and fluoroscopy to diagnose and treat
certain problems of the biliary or pancreatic ductal systems. This study aims to
describe ERCP in Prof. Dr. R. D. Kandou General Hospital in indications, diagnosed
conditions and laboratory findings

Method: This study is retrospective study of patients underwent ERCP from January
2017- May 2019 in Division of Digestive Surgery, Surgery Department of Prof. Dr.
R. D. Kandou General Hospital, Manado, Indonesia.Result: A total of 25 patients
data was available, 13 males (52%) and 12 ( 48%) females. The highest number of
patients indicated of undergoing ERCP were 18 patients (72%) because of jaundice,
abdominal pain in upper right quadrant 6 patients (24%), post biliary stenting
procedure 1 patient (4%). There were 13 patients (52%) diagnosed with
Choledocholithiasis, 3 patient was failed to extract the stone due to difficulties in
cannulation of the Ampulla of Vater. 11 patients (44%) were diagnosed with tumor
and the procedure had to be stopped in 1 patient (4%) due to instrument failure. The
elevated of total bilirubin and direct bilirubin were decreased after ERCP in 10
patients (40%). Conclusion: ERCP can be a choice procedure to diagnose and to treat
condition associated with pancreaticobiliary system and as the learning curve of
ERCP experienced that can improved surgeon confidence.

Keywords: ERCP, jaundice, choledocholithiasis, bilirubin

Experience of laparoscopic common bile duct exploration in A. Wahab Sjahranie
Hospital, Samarinda-Indonesia

Isa Basuki, Bambang Suprapto

Resident of General Surgery, Department of Digestive Surgery A. Wahab Sjahranie

Hospital/ Mulawarman University, Indonesia

Introduction: Laparoscopic common bile duct (CBD) exploration is a choice to

extract stone, evaluate biliary tract or biopsy. We aim to report our results with this
procedure, focusing on the technical aspects. Herein we describe our 3-year
experience with laparoscopic common bile duct exploration (LCBDE)

Method: We performed LCBDE for 21 patients with CBD stone from June 2017 -
April 2019. MRCP or MSCT done for diagnosis preoperatively. All CBD exploration
was done by video choledoscope. Route LCBDE, duration, conversion rate, biliary
tract clearance and complication will be evaluated.

Result: Among 21 patients, male was 8 (38.1%) and female 13 (61.9%), mean age
was 44 year, in range 28 - 74 years, TC-LCBDE in 6 (28.6%) patients and C-LCBDE
in 15 (71.4%) patients. Extraction CBD stone or bypass and biopsy done. The largest
CBD stone was 20 mm, in range 2 - 20 mm and 1 - 6 stones extract/clearance by
basket or forceps. No major complication, 1 (4.8%) was converted to open due to
adhesion. Mean operative time was 215.95 minutes, in range 75 - 345 minutes.
Majority choledochotomy was done with primary closure and subhepatic drain was
placed, only 1 (4.8%) with T-Tube. All CBD clearance was ensured by video
choledoscope. Mean postoperative length of stay was 4.76 days, in range 2 - 15 days.

Conclusion: LCBDE is a feasible, safe and effective procedure with low

complication and higher success rate for biliary tract clearance and cholecystectomy
(single stage approach). Choledoscope is a must to evaluate biliary tract and biopsy.

Keywords: exploration, surgery, laparoscopic.

Chilaiditi syndrome: a case series and systematic review

Putu Chandra Wibawa1, Ketut Wiargitha21General Surgery Resident, Faculty Of

Medicine Udayana University, Sanglah General Hospital, Denpasar, Bali 2Trauma
Consultant, Department of General Surgery, Udayana University, Sanglah General
Hospital, Denpasar, Bali

Introduction: Chilaiditi’s syndrome, temporary or permanent interposition of the

colon in the hepato-diaphragmatic space, could be presented with various symptoms.
Case: We reported two cases of Chilaiditi syndrome with the different chief of
complaint when admitted to the hospital. A 35-year-old woman with epigastric pain
and a 67-year-old man with shortness of breath. Physical examination was not
specific for both patients. However, plain radiograph showed an elevated right
hemidiaphragm and the presence of subphrenic air, making the diagnosis of Chilaiditi
syndrome. Both patients were managed conservatively with nasogastric tube
decompression and intravenous fluid. The follow up showed favorable results and
symptoms resolved.

Conclusion: Clinicians should be more aware of the diagnosis of Chilaidity syndrome

with its various symptoms. Radiological evidence should be obtained for the
confirmed diagnosis, and conservative management was the modality choice.
Neuroendocrine tumors of the colon: serial case reports

Liliyanto, Kusuma M. Ihwan

Department of Digestive Surgery Faculty of Medicine, Universitas Hasanuddin,

Wahidin Sudirohusodo Hospital, Makassar

Background: Neuroendocrine tumors (NETs) are a group of very rare and

heterogenic. NETs are characterized histologically with endocrine tissue intracellular
marker, like chromogranin. These tumors can occur everywhere in body, but the most
common site is in gastrointestinal tract which commonly called carcinoid tumor.

Case: We had 2 patients with neuroendocrine carcinoma presenting to our hospital.

One came with clinically diagnosed as peritonitis and the other one was diagnosed
with intestinal obstruction. Both patients were operated. Conclusion: GEP-NET is
relatively rare neoplasms of the gastrointestinal tract with variable clinical
presentation, morbidity, and mortality dependent on tumor location, metastatic
potential, and functional biologic status. Staging and classification systems for GEP-
NET are likely to continue to evolve along with further development of tumor-
directed diagnostic and therapeutic modalities as our understanding of GEP-NET
continues to expand over time.

Keywords: neuroendocrine, carcinoid, gastrointestinal, tumors.

A male teenager with prolapsed omentum per rectum after anal intercourse:
case report

Bhastiyan Danang Wijanarko1, Martin Saputrowardoyo2, Reinaldo Sunggiardi2

1Emergency Department, Bengkayang Government Hospital, Bengkayang, Indonesia
2Surgery Departement, Faculty of Medicine Hasanuddin University, Makassar,
Indonesia

Background: Injuries during anal intercourse can range from superficial mucosal
bleeding to severe ones that can lead to rupture of rectum with peritonitis, which are
usually related with foreign body insertion.Case Presentation: We report a 19-year
old male with prolapse mass from anal, who presented in our emergency department
with acute abdominal pain 48 hours after anal intercourse and foreign body insertion
to the anal. From laparotomy, there was fecal peritonitis from a large rectal tear in the
upper third of the rectum rectal and primary repair was performed. The unique feature
of this case is that the post coitus tear of the rectum caused by anal intercourse and
foreign bodies insertion via anal between two homosexual adults resulted in
intraperitoneal peritonitis, while the anal sphincters were left intact Conclusion:
Sexual related traumas are unique case subjects as well as the cause of embarrassment
and distress to most patients. Depending on our east cultural and social etic, patients
mostly delay referral to hospital, fabricate some fake stories, and hide the thorough
history.

Keywords: rectal perforation, anal intercourse, foreign body insertion, sexual related
trauma.
Cloacal type anorectal malformation in controlled patients after 37 years of
colostomy diversion: a case report

Reza Arif Fadillah, Rizki Diposarosa

Pediatric Surgery Division, Department of Surgery, Faculty of Medicine Padjadjaran

University / RSUP Dr. Hasan Sadikin Bandung

Background: Atresia anal, now known as anorectal malformation (MAR), is a

congenital disorder that shows a condition without anus or with an imperfect anus.
Anorectal malformation is a disease that is often found in pediatric surgery patients.
Anorectal malformation is one of the causes of obstruction of fecal discharge in the
anus and causes obstructive ileus in infants. Especially for cloacal type defects in
women can be performed colostomy, vaginectomy and diverted urine if necessary
(after older children 1 - 1.5 years). Cases of cloaca type congenital malformations that
have been allowed to occur for 37 years are very rare cases. Therefore, this case is a
very rare case so it is interesting to be appointed and discussed.

Case: A woman, 37 years old, came to the pediatric surgery department of Dr. Hasan
Sadikin General Hospital with a preoperative diagnosis: a post colostomy cloacal
anorectal malformation; vaginal agenesis; urinary retention et causa colpolithiasis.
The symptoms are the patient do not have an anal opening. Defecation can through a
hole under the vagina. Complaints are not accompanied by an enlarged abdomen, no
fever, no hypersalivation, no symptoms of blue lips when crying. Then an operation
was made to make colostomy while the age of 2 weeks, since then the patient
defecated through the stoma. The patient had been planned to have surgery by a
pediatric surgeon at the age of > 1 year but no room was obtained so the patient
delayed the surgery plan. The patient then controls to the digestive surgery
department after aged 37 years. Therapy is carried out in the form of joint surgery
between pediatric surgery, obstetric- gynecologist, digestive surgery, and urology
surgeon. The surgical procedure is hysterotomy; vaginoplasty; evacuation of
colpolithiasis; uretrocystoscopy; cystostomy; ureterostomy; urethroplasty; stoma
relocation; posterosagital pull anorectoplasty; ureterovesicocutan.

Conclusion: This case opens a new gap in the field of science in handling anorectal
malformations in adulthood by maintaining a colostomy for 37 years. Do you need
anorectal malformation repair done by the age of infants and children or can it be
done in adulthood? Associated with patient safety and specialist doctors in the era of
National Health Insurance (JKN).

Keywords: anorectal malformation (mar), stoma, colpolithiasis, urine retention.

Experience of laparoscopic common bile duct exploration in A. Wahab Sjahranie
Hospital, Samarinda-Indonesia

Isa Basuki, Bambang Suprapto

Resident of General Surgery, Department of Digestive Surgery A. Wahab Sjahranie

Hospital/ Mulawarman University, Indonesia

Introduction: Laparoscopic common bile duct (CBD) exploration is a choice to

extract stone, evaluate biliary tract or biopsy. We aim to report our results with this
procedure, focusing on the technical aspects. Herein we describe our 3-year
experience with laparoscopic common bile duct exploration (LCBDE)

Method: We performed LCBDE for 21 patients with CBD stone from June 2017 -
April 2019. MRCP or MSCT done for diagnosis preoperatively. All CBD exploration
was done by video choledoscope. Route LCBDE, duration, conversion rate, biliary
tract clearance and complication will be evaluated.

Result: Among 21 patients, male was 8 (38.1%) and female 13 (61.9%), mean age
was 44 year, in range 28 - 74 years, TC-LCBDE in 6 (28.6%) patients and C-LCBDE
in 15 (71.4%) patients. Extraction CBD stone or bypass and biopsy done. The largest
CBD stone was 20 mm, in range 2 - 20 mm and 1 - 6 stones extract/clearance by
basket or forceps. No major complication, 1 (4.8%) was converted to open due to
adhesion. Mean operative time was 215.95 minutes, in range 75 - 345 minutes.
Majority choledochotomy was done with primary closure and subhepatic drain was
placed, only 1 (4.8%) with T-Tube. All CBD clearance was ensured by video
choledoscope. Mean postoperative length of stay was 4.76 days, in range 2 - 15 days.

Conclusion: LCBDE is a feasible, safe and effective procedure with low

complication and higher success rate for biliary tract clearance and cholecystectomy
(single stage approach). Choledoscope is a must to evaluate biliary tract and biopsy.

Keywords: exploration, surgery, laparoscopic

Long term clinical outcome of gastrointestinal stromal tumor undergoing
resection and adjuvant tyrosine kinase inhibitor

Danar Widyatmoko1, Budhi Ida Bagus21General surgery Resident, Faculty of

Medicine Sebelas Maret University/Dr. Moewardi Hospital Surakarta 2Consultant
Division of Digestive Surgery at Faculty of Medicine Sebelas Maret University / Dr.
Moewardi Hospital Surakarta

Background: Gastrointestinal stromal tumor (GIST) is the most common

mesenchymal tumor in the digestive tract, patiens with larger tumor size and high
mitotic count have a high risk of recurrence after surgery. Standard treatment of
localized GIST is complete surgical resection associated with adjuvant imatinib
( tyrosine kinase inhibitor) therapy. Reccurence rate and survival rate can be obtained
by imatinib ( tyrosine kinase inhibitor) therapy, which already been proved to have a
clinical efficacy for metastasis.

Methods: We evaluated five cases of resectable gastrointestinal stromal tumor in 3

different site from 2012 until 2014. Adjuvant tyrosine kinase inhibitor was given
during 1 year period after surgery. Resection status of those cases were recorded,
including tumor location and type of resection. Three years survival of the patients
were evaluated along with the quality of life after surgery. Result: Two patients had
gastric GIST, ileal GIST was found in one patient, jejunal GIST was found in one
patient. Multiple organ involvemnet was found on jejunal and tranverse colon GIST.
Completed R0 resection can be done in four patient with good clinical outcome after
achieving tyrosine kinase inhibitor and 3 years follow-up. One patient did not survive
after follow up, and has R1 resection status. Gastrointestinal related symptoms like
diarhea was the most common side effect following tyrosine kinase inhibitor therapy
and could tolerated well by the patients.

Conclusion: Resectable gastrointestinalstromal tumor has good outcome after

receiving adjuvant tyrosine kinase inhibitor for 1 year, R status play important role on
prognosis in this case.Keywords: Gastrointestinalstromal tumor, Positive CD-117,
Tyrosine Kinase Inhibitor.
Hepatic vein re-anastomosis, intraoperative challenges during liver
transplantation in emerging liver transplant center: a case report

Kshetra Rinaldhy, Mohammad Febriadi Ismet, Rizky Amalia, Trihening

Rahayatri, Ahmad Yani, SastionoLiver Transplant Team, Pediatric Surgery
Division, Department of Surgery, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Introduction: Hepatic vein anastomosis on liver transplantation has been considered

as a very important part to ensure good outflow of liver graft. We report and review a
case of intraoperative challenges during hepatic vein anastomosis on pediatric living
donor liver transplantation (LDLT) in Dr. Cipto Mangunkusumo Hospital, a new
emerging LDLT center.

Case: Twenty months old female patient diagnosed with biliary atresia with previous
Kasai surgery received left lateral liver graft from her father donor. The graft had 2
openings of left hepatic vein and superficial vein which was sutured into single orifice
in the back table. Left hepatic vein liver graft was anastomosed to a new wide orifice
on the recipient’s IVC connecting all 3 hepatic veins. Intraoperative ultrasound
showed low flow of hepatic vein after reperfusion. Reanastomosis was performed 3
times, including re-anastomosis using donor ovarian vein patch in 18 hours surgery.
Postoperative complication hepatic venous outflow obstruction (HVOO) was
successfully dilated with 9 mm balloon catheter on interventional radiography
venoplasty procedure at postoperative day 70.

Conclusion: Hepatic vein anastomosis and prevention of HVOO should be a high

priority in LDLT. In grafts with multiple hepatic veins, the use of a patch graft is
recommended. Postoperative follow-up imaging and minimally invasive treatment for
HVOO such as balloon venoplasty should be performed afterward. Keywords:
hepatic vein anastomosis, hepatic venous outflow obstruction, new transplant center
Characteristic of abdominal blunt trauma patients who performed surgery at
Hasan Sadikin General Hospital Bandung in period 1 st January 2016 to 31st
December 2018

Novi Christina Indrajaya, Reno Rudiman

Digestive Surgery Division, General Surgery Department, Medical Faculty

Padjadjaran University/ Hasan Sadikin General Hospital Bandung

Background: Abdominal blunt trauma is ranked the 3 rd largest in the world which
causes morbidity and mortality. The common cause is traffic accidents, falls, and hits.
Diagnosis and proper management are important in reducing death. More than one-
third of abdominal trauma patients who require emergency surgery (emergency
laparotomy) initially have blurred sign and symptom. To find out the characteristics
of abdominal blunt trauma patients who performed surgery at Hasan Sadikin General
Hospital Bandung in period 1st January 2016 until 31st December 2018.

Methods: Data was taken from the medical records in period 1st January 2016 until
31st December 2018.Results: 92 medical record data of patients with abdominal blunt
trauma who performed the surgery. 79 patients (86%) are men, 44 patients (48%) at
the age of 17 - 25 years, 55 patients (60%) caused by 2-wheeled vehicle accidents,
and the most organs were liver, which was 22 patients (24%). 58 patients (63%)
peritonitis condition were performed immediate surgery. 40 patients (43%) were
treated in hospital during 15 - 21 days.

Conclusion: Abdominal blunt trauma most common occur in men, caused by motor
vehicle accidents, with injured organ is the liver. Peritonitis is the most common
reason of surgery.Keywords: Abdominal blunt trauma, emergency laparotomy,
surgery, peritonitis.