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"[Pendahuluan: Epidemiologi forensik merupakan disiplin ilmu yang dapat digunakan untuk menyelesaikan suatu investigasi kasus. Dengan pendekatan ini, dapat ditentukan adanya hubungan antara suatu paparan dengan cedera atau dampak yang terjadi. Salah satu paparan yang banyak ditemukan di Indonesia ialah kekerasan fisik, termasuk kekerasan tumpul. Kekerasan tumpul menempati 70,9% proporsi jenis cedera. Abdomen merupakan salah satu bagian tubuh yang rentan mengalami kerusakan akibat kekerasan fisik dikarenakan strukturnya yang lemah dan kendur karena tidak dilindungi oleh tulang, melainkan hanya tersusun atas kulit, fascia, dan otot yang membentuk dinding rongga abdomen. Kerusakan organ dalam di daerah abdomen sulit diidentifikasi karena umumnya tidak ditemukan adanya bentuk luka khas pada pemeriksaan fisik luar. Oleh sebab itu, pada penelitian ini akan dianalisis hubungan antara temuan luka pada kekerasan tumpul di abdomen dengan kerusakan organ dalamnya.Metode: Penelitian ini dilakukan dengan desain cross-sectional berdasarkan data sekunder berupa laporan visum dan rekam medis Rumah Sakit Cipto Mangunkusumo tahun 2003-2013 dengan metode consecutive sampling.Hasil: Hasil penelitian menunjukkan bahwa terdapat hubungan bermakna antara temuan luka lecet atau memar di beberapa regio abdomen dengan kerusakan organ tertentu. Penelitian ini dilakukan dengan subjek laki-laki sebanyak 25 orang (69,44%) dan perempuan sebanyak 11 orang (30,56%) dengan kelompok usia terbanyak pada 21-40 tahun sejumlah 14 kasus (28,89%). Dari uji hipotesis Fisher diperoleh hubungan yang bermakna secara statistik antara temuan luka kekerasan tumpul (lecet dan memar) di epigastrium dengan kerusakan ginjal kiri (p = 0,028), temuan luka kekerasan tumpul di epigastrium dengan kerusakan lambung (p = 0,042), temuan luka kekerasan tumpul di umbilikus dengan kerusakan lambung (p = 0,042), temuan luka kekerasan tumpul di umbilikus dengan kerusakan pankreas (p = 0,042), temuan luka kekerasan tumpul di hipokondria kiri dengan kerusakan hati (p = 0,006), dan temuan luka kekerasan tumpul (lecet dan memar) di hipogastrium dengan kerusakan hati (p = 0,023).Pembahasan: Adanya hubungan antara temuan luka luar di abdomen dengan kerusakan organ dalam dimungkinkan akibat keterkaitan secara anatomi, baik karena dampak tekanan secara langsung maupun tidak langsung yang dihantarkan oleh otot ataupun organ lainnya yang terletak berdekatan.;Introduction: Forensic epidemiology can be used to solve the criminal cases. This approach may determine the correlation between an exposure and the damages caused by the trauma. In Indonesia, blunt trauma account for 70,9% injury. Abdomen is part of the human body that vulnerable to damage caused by force injury as intra-abdominal organs consist of delicate and soft structure which aren’t completely protected by bones. Damage to the intra-abdominal organs are difficult to recognize as it is uncommon to find the definite external wound. This study is conducted to analyze the association between external wound caused by blunt trauma and the damage to the intra-abdominal organs.Method: This study is a cross-sectional study, using secondary data from forensic examination report and medical record of Cipto Mangunkusumo Hospital in 2003-2013 with consecutive sampling method.Result: The result implicates there was association between scratch or bruise wound from external forensic examination in various abdomen regions and damage to intra-abdominal organs. The study involved 25 males (69,44%), 11 females (30,56%), and most of the subjects were aged 21-40 years in 14 cases (28,89%). By performing Fisher test: there was significant association between scratches or bruises in the epigastrium and damage to the left kidney (p = 0,028), significant association between scratches or bruises in the epigastrium and damage to the stomach (p = 0,042), significant association between scratches or bruises in the umbilicus and damage to the stomach (p = 0,042), significant association between scratches or bruises in the umbilicus and damage to the pancreas (p = 0,042), significant association between scratches or bruises in the left hypochondriac and damage to the liver (p = 0,006), and significant association between scratches or bruises in the hypogastrium and damage to the stomach (p = 0,023).Discussion: The correlation between external wound in abdomen and the organ damages could be caused by anatomical association or indirect impact from the other adjacent organs;Introduction: Forensic epidemiology can be used to solve the criminal cases. This approach may determine the correlation between an exposure and the damages caused by the trauma. In Indonesia, blunt trauma account for 70,9% injury. Abdomen is part of the human body that vulnerable to damage caused by force injury as intra-abdominal organs consist of delicate and soft structure which aren’t completely protected by bones. Damage to the intra-abdominal organs are difficult to recognize as it is uncommon to find the definite external wound. This study is conducted to analyze the association between external wound caused by blunt trauma and the damage to the intra-abdominal organs.Method: This study is a cross-sectional study, using secondary data from forensic examination report and medical record of Cipto Mangunkusumo Hospital in 2003-2013 with consecutive sampling method.Result: The result implicates there was association between scratch or bruise wound from external forensic examination in various abdomen regions and damage to intra-abdominal organs. The study involved 25 males (69,44%), 11 females (30,56%), and most of the subjects were aged 21-40 years in 14 cases (28,89%). By performing Fisher test: there was significant association between scratches or bruises in the epigastrium and damage to the left kidney (p = 0,028), significant association between scratches or bruises in the epigastrium and damage to the stomach (p = 0,042), significant association between scratches or bruises in the umbilicus and damage to the stomach (p = 0,042), significant association between scratches or bruises in the umbilicus and damage to the pancreas (p = 0,042), significant association between scratches or bruises in the left hypochondriac and damage to the liver (p = 0,006), and significant association between scratches or bruises in the hypogastrium and damage to the stomach (p = 0,023).Discussion: The correlation between external wound in abdomen and the organ damages could be caused by anatomical association or indirect impact from the other adjacent organs;Introduction: Forensic epidemiology can be used to solve the criminal cases. This approach may determine the correlation between an exposure and the damages caused by the trauma. In Indonesia, blunt trauma account for 70,9% injury. Abdomen is part of the human body that vulnerable to damage caused by force injury as intra-abdominal organs consist of delicate and soft structure which aren’t completely protected by bones. Damage to the intra-abdominal organs are difficult to recognize as it is uncommon to find the definite external wound. This study is conducted to analyze the association between external wound caused by blunt trauma and the damage to the intra-abdominal organs.Method: This study is a cross-sectional study, using secondary data from forensic examination report and medical record of Cipto Mangunkusumo Hospital in 2003-2013 with consecutive sampling method.Result: The result implicates there was association between scratch or bruise wound from external forensic examination in various abdomen regions and damage to intra-abdominal organs. The study involved 25 males (69,44%), 11 females (30,56%), and most of the subjects were aged 21-40 years in 14 cases (28,89%). By performing Fisher test: there was significant association between scratches or bruises in the epigastrium and damage to the left kidney (p = 0,028), significant association between scratches or bruises in the epigastrium and damage to the stomach (p = 0,042), significant association between scratches or bruises in the umbilicus and damage to the stomach (p = 0,042), significant association between scratches or bruises in the umbilicus and damage to the pancreas (p = 0,042), significant association between scratches or bruises in the left hypochondriac and damage to the liver (p = 0,006), and significant association between scratches or bruises in the hypogastrium and damage to the stomach (p = 0,023).Discussion: The correlation between external wound in abdomen and the organ damages could be caused by anatomical association or indirect impact from the other adjacent organs, Introduction: Forensic epidemiology can be used to solve the criminal cases. This approach may determine the correlation between an exposure and the damages caused by the trauma. In Indonesia, blunt trauma account for 70,9% injury. Abdomen is part of the human body that vulnerable to damage caused by force injury as intra-abdominal organs consist of delicate and soft structure which aren’t completely protected by bones. Damage to the intra-abdominal organs are difficult to recognize as it is uncommon to find the definite external wound. This study is conducted to analyze the association between external wound caused by blunt trauma and the damage to the intra-abdominal organs.Method: This study is a cross-sectional study, using secondary data from forensic examination report and medical record of Cipto Mangunkusumo Hospital in 2003-2013 with consecutive sampling method.Result: The result implicates there was association between scratch or bruise wound from external forensic examination in various abdomen regions and damage to intra-abdominal organs. The study involved 25 males (69,44%), 11 females (30,56%), and most of the subjects were aged 21-40 years in 14 cases (28,89%). By performing Fisher test: there was significant association between scratches or bruises in the epigastrium and damage to the left kidney (p = 0,028), significant association between scratches or bruises in the epigastrium and damage to the stomach (p = 0,042), significant association between scratches or bruises in the umbilicus and damage to the stomach (p = 0,042), significant association between scratches or bruises in the umbilicus and damage to the pancreas (p = 0,042), significant association between scratches or bruises in the left hypochondriac and damage to the liver (p = 0,006), and significant association between scratches or bruises in the hypogastrium and damage to the stomach (p = 0,023).Discussion: The correlation between external wound in abdomen and the organ damages could be caused by anatomical association or indirect impact from the other adjacent organs]"

"ABSTRAKCedera kepala traumatik merupakan penyebab kematian tersering pada kecelakaan. Trauma tumpul pada kepala dapat menimbulkan contusio cerebri berupa lesi coup dan contrecoup. Namun, mekanisme dari terjadinya lesi coup dan contrecoup belum diketahui dengan jelas. Penelitian ini dilakukan untuk mengetahui hubungan antara letak trauma tumpul pada kepala dengan terjadinya lesi coup dan contrecoup.Metode: Sampel penelitian diambil dari rekam medis jenazah dengan trauma tumpul pada kepala yang diotopsi di Departemen Forensik dan Medikolegal RSCM pada tahun 2012-2016. Peneliti kemudian mencari tahu mengenai letak trauma tumpul dan temuan contusio cerebri pada rekam medis jenazah.Hasil: Dari 97 sampel dengan trauma tumpul pada kepala, didapatkan proporsi lesi coup sebesar 5,2 , 11,3 , dan 2,1 , dan proporsi lesi contrecoup sebesar 1,0 , 15,5 , dan 2,1 pada trauma tumpul yang terjadi di depan, samping, dan belakang kepala secara berturut-turut. Hasil uji chi square menunjukkan hubungan yang bermakna antara trauma tumpul pada sisi depan p=0,005 dan samping p=0,002 kepala dengan lesi contrecoup.Pembahasan: Terjadinya lesi coup tidak selalu diikuti oleh terjadinya lesi contrecoup, dan berlaku juga sebaliknya. Hubungan bermakna antara trauma tumpul pada sisi samping kepala dengan lesi contrecoup secara teori dapat dikaitkan dengan teori sistem suspensori otak.Kesimpulan: Dari penelitian ini, dapat disimpulkan bahwa terdapat hubungan antara trauma tumpul pada sisi depan dan samping kepala dengan lesi contrecoup.

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ABSTRACTTraumatic brain injury remains the most common cause of mortality in accidents. Blunt trauma in the head may cause cerebral contusion, which includes coup and contrecoup contusion. However, the mechanism of coup and contrecoup contusion formation remains unknown. This research aims to know the relationship between the position of head blunt trauma with coup and contrecoup contusion.Methods Research samples were taken from corpse medical records with head blunt trauma who had undergone autopsy in Forensics and Medicolegal Department of Cipto Mangunkusumo Hospital from 2012 2016. The position of head blunt trauma and findings of cerebral contusions were recorded.Results Out of 97 samples with head blunt trauma, the proportions for coup contusion were 5,2 , 11,3 , and 2,1 , while the proportions for contrecoup contusion were 1,0 , 15,5 , and 2,1 in blunt trauma happening at the front, side, and back part of the head respectively. Chi square tests showed significant relationships between blunt trauma of front p 0,005 and side p 0,002 part of the head with contrecoup contusion.Discussion Coup contusion is not always followed by contrecoup contusion, and vice versa. The significant relationship between blunt trauma of the side part of the head and contrecoup contusion can be explained by the theory of brain suspensory system.Conclusion This research concludes that blunt trauma of the front and side part of the head is related to contrecoup contusion."