BAGIAN ILMU RADIOLOGI REFERAT

FAKULT
FAKULTAS
AS KEDOKTERAN OKTOBER 2016
UNIVERSITAS MUSLIM INDONESIA

 RUPTUR BULI-BULI

DISUSUN OLEH:
Aldila Dea Amalinda
111
111 2015 2269

PEMBIMBIN
d!" S!ie Re#n$ Enda% R"S& S'"Rad& M"(e)

DIBAWAKAN DALAM RANGKA TUGAS KEPANITERAAN KLINIK 

BAGIAN ILMU KEDOKTERAN JIWA
JIWA
FAKULTAS KEDOKTERAN
UNIVERSITAS MUSLIM INDONESIA
MAKASSAR 
2016

1
I"A" La#a! Bela*an+
Trauma bul!bul m"ru#a$a% $"a&aa% &arura' b"&a( )a%* m"m"rlu$a%
 #"%a'ala$+a%aa% +"*"ra,-1. #a&a /"&"ra +$ )a%* m"m"rlu$a% '%&a$a%
 #"mb"&a(a% a$u' &&a#a'$a% ba(a 10
10 &a%'ara%)a a&ala( a$ba' &ar 'rauma
'um#ul &&a"ra( ab&3m"%4 -2. bla '&a$ &'a%**ula%* &"%*a% +"*"ra, &a#a'
m"%mbu$a% $3m#l$a+, +"#"r' #"r'3%'+ &a% +"#++4 -1. P"%**u%aa% USG #a&a
$a+u+ 'rauma a$u' m"%%*$a' +"/ara &rama'+ &alam 50 'a(u% '"ra$(r4 Pa&a 170!
a%, USG #"r'ama $al &*u%a$a% u%'u$ m"%&a*%3+a ("m3#"r'3%"um &alam
 #"%a%*a%a% 'rauma 'um#ul ab&3m"%4-5.
P"%)"bab umum #"/a(%)a $a%&u%* $"m( m"l#u' &am#a$ la%*+u%*
&"%*a% +"'r a'au +abu$ #"%*ama% $"/"la$aa% $"%&araa% b"rm3'3r &a% +"ra%*a%
$" #"ru' ba*a% baa( &"%*a% '"%&a%*a% a'au #u$ula%4 K"mu%*$%a% 'rauma
 bul!bul +"/ara la%*+u%* b"r$a'a% &"%*a% '%*$a' &+'"%+ #a&a +aa' /"&"ra,
&"%*a% $a%&u%* $"m( #"%u( l"b( /"%&"ru%* #"/a( &ar +a'u $3+3%*4 S"bua(
$"/ur*aa% $l%+ )a* '%** &a% &a*%3++ )a%* +"*"ra a&ala( $u%/ u%'u$
 #"raa'a% m"&+ a'au 3#"ra+ )a%* +u$+"+4 Pa+"% &"%*a% ra$'ur #a%**ul
m"ml$ r"+$3 '%** lu$a $a%&u%* $"m(, &a% $"mu%*$%a% /"&"ra $a%&u%*
$"m( +"/ara la%*+u%* b"r(ubu%*a% &"%*a% '%*$a' $"#ara(a% ra$'ur4 A&a
A&a 8u*a
(ubu%*a% a%'ara '%** #"/a( $a%&u%* $"m( &a% *a%**ua% ur"'ra4 -9.

I"B" Anatomi
am,a!an Umm Bli-Bli ./e)ia U!ina!ia
Bul!bul a&ala( 3r*a% "$+'ra#"r'3%"al )a%* '"rl"'a$ & &alam r3%**a
 Retzius4
 Retzius4 D &"#a% a&a $a'a% &"%*a% ++m++ #"l:+, &a% la'"ral 3l"( l*am"%'um
umbl/u+, mu+$ulu+ 3b'ura'3r %'"r%u+ &a% 'ula%*!'ula%* #"l:+4 D baa( bul!
 bul &a% #r3+'a' a&a l*am"%' )a%* m"%/a%'"l$a% &r #a&a &ara*ma ur3*"%'al4
ur3*"%'al4
D b"la$a%* bul!bul &ba'a+ 3l"( r"/'um4 Da+ar bul!bul b"r(ubu%*a% &"%*a%
 #"r'3%"um &a% &ba'a+ #a&a '*a ++ 3l"( 'ula%*!'ula%* #"l:+4-;.
Bul!bul m"ru#a$a% 3r*a% b"r3%**a )a%* '"r&r a'a+ 5 la#+ 3'3' &"'ru+3r
)a%* +al%* b"ra%)ama%, )a$% -1. & +"b"la( &alam a&ala( 3'3' l3%*'u&%al, -2.
& '"%*a( m"ru#a$a% 3'3' +r$ul"r, -5. &a% #al%* luar m"ru#a$a% 3'3'
l3%*'u&%al4 Mu$3+a bul!bul '"r&r a'a+ +"l!+"l 'ra%++3%al )a%* +ama +"#"r'

2
 #a&a mu$3+a!mu$3+a #a&a #"l:+ r"%al+, ur"'"r, &a% ur"'ra #3+'"r3r4 Pa&a &a+ar
 bul!bul $"&ua muara ur"'"r &a% m"a'u+ ur"'ra %'"r%um m"mb"%'u$ +ua'u
+"*'*a )a%* &+"bu' 'r*3%um bul!bul4 -6.
S"/ara a%a'3m$ b"%'u$ bul!bul '"r&r a'a+ 5 #"rmu$aa%, )a'u -1.
 #"rmu$aa% +u#"r3r )a%* b"rba'a+a% &"%*a% r3%**a #"r'3%"um, -2. &ua
 #"rmu$aa% %"r3la'"ral, &a% -5. #"rmu$aa% #3+'"r3r4 P"rmu$aa% +u#"r3r
m"ru#a$a% lokus minoris -&a"ra( '"rl"ma(. &%&%* bul!bul4 -6.
Bul!bul b"ru%*+ m"%am#u%* ur%" &ar ur"'"r &a% $"mu&a%
m"%*"luar$a%%)a m"lalu ur"'ra &alam m"$a%+m" m$+ -b"r$"m(.4 Dalam
m"%am#u%* ur%", bul!bul m"m#u%)a $a#a+'a+ ma$+mal, )a%* :3lum"%)a
u%'u$ 3ra%* &"a+a $ura%* l"b( a&ala( 500 < 9;0 ml= +"&a%*$a% $a#a+'a+ bul!
 bul #a&a a%a$ m"%uru' 3rmula &ar K3 a&ala(>

Ka#a+'a+ bul!bul ? @Umur -'a(u%.  2 C 50 ml-6.

Pa&a +aa' $3+3%*, bul!bul '"rl"'a$ & b"la$a%* +m++ #ub+ &a% #a&a
+aa' #"%u( b"ra&a & a'a+ +m++ +"(%**a &a#a' &#al#a+ &a% &#"r$u+4 Bul!
 bul )a%* '"r+ #"%u( m"mb"r$a% ra%*+a%*a% #a&a +ara a"r"% &a%
m"%)"bab$a% a$':a+ #u+a' m$+ & m"&ula +#%al+ +"*m"% +a$ral S 2!94 al %
a$a% m"%)"bab$a% $3%'ra$+ 3'3' &"'ru+3r, '"rbu$a%)a l"("r bul!bul, &a%
r"la$+a+ +%*'"r ur"'ra +"(%**a '"r8a&la( #r3+"+ m$+4-6.

A B

-7.
Gambar 14 A%a'3m V"+/a Ur%ara4 A4V"+/a Ur%ara #"r"m#ua% #3'3%*a% /3r3%al 4 B4 V"+/a Ur%ara
la$!la$ #3'3%*a% /3r3%al -7.4 4 V"+/a Ur%ara la$!la$ 'am#a$ #3+'"r3r -.4

3
Ben#* dan Pe!m*aan /e)ia U!ina!ia
V"+/a ur%ara )a%* $3+3%* b"rb"%'u$ #)ram&, m"m#u%)a a#"C, ba++,
&a% +"bua( a/"+ +u#"r3r +"r'a &ua bua( a/"+ %"r3la'"ral+= 8u*a m"m#u%)a
/3llum4-.
A'e :"+/a" ur%ara" m"%*ara( $" &"#a% &a% '"rl"'a$ & b"la$a%*
 #%**r a'a+ +)m#(++ #ub+4 -.
Ba)i)& a'au 3aie) '$)#e!i$! :"+/a", m"%*(a&a# #3+'"r3r &a% b"rb"%'u$ 
+"*'*a4 Su&u' +u#"r3la'"ral+ m"ru#a$a% '"m#a' muara ur"'"r, &a% +u&u' %"r3r 
m"ru#a$a% '"m#a' a+al ur"'(ra4 -.
4aie) )'e!i$! :"+/a" &l#u' #"r'3%"um &a% b"rba'a+a% &"%*a%
-.
l"%*$u%* l"um a'au /3l3% +*m3&"um4
Bla :"+/a ur%ara '"r+, b"%'u$%)a m"%8a& l3%83%*, #"rmu$aa%
+u#"r3r%)a m"mb"+ar &a% m"%3%83l $" a'a+, $" &alam /a:'a+ ab&3m%al+4 -
4aie) in3e!$la#e!ali) & &"#a% b"rba'a+a% &"%*a% ,an#alan lema* 
-.
!e#!$',i) &a% 3+ #ub+4
$llm e)iae '"rl"'a$ & %"r3r &a% #a&a la$!la$ '"rl"'a$ #a&a
 #"rmu$aa% a'a+ #r3+'a'4 -.

Pe!m*aan In#e!i$! /e)ia U!ina!ia

Ar"a 'u%/a mu/3+a )a%* m"l#u' #"rmu$aa% &alam ba++ :"+/a"
ur%ara" &%ama$a% #!i+$nm e)iae4 Tu%/a mu/3+a +"lalu l/%, alau#u%
&alam $"a&aa% $3+3%*, $ar"%a m"mbra%a mu$3+a #a&a 'r*3%um % m"l"$a'
&"%*a% "ra' #a&a la#+a% 3'3' )a%* a&a & baa(%)a4  -.
Su&u' +u#"r3r 'r*3%um % m"ru#a$a% '"m#a' muara &ar ur"'"r &a%
-.
+u&u' %"r3r%)a m"ru#a$a% 3rr/um ur"'(ra %'"r%um4

4
 Ula e)iae m"ru#a$a% '3%83la% $"/l )a%* '"rl"'a$ '"#a' & b"la$a%*
3r/um ur"'(ra" )a%* &+"bab$a% 3l"( l3bu+ m"&a%u+ #r3+'a'" )a%* a&a &
 baa(%)a4 -.

Tnia M)la!i) /e)ia U!ina!ia

Tu%/a mu+/ular+ :"+/a ur%ara '"r&r a'a+ 3'3' #3l3+ )a%* '"r+u+u%
&alam '*a la#+ )a%* +al%* b"r(ubu%*a% )a%* &+"bu' +"ba*a m)l)
de#!)$! e)iae 4 Pa&a /3llum :"+/a", $3m#3%"% +r$ula+ &ar la#+a% 3'3' %
m"%"bal m"mb"%'u$ m)l) )'%in#e! e)iae 4 -.

Li+amen#m-Li+amen#m 'ada /e)ia U!ina!ia

3llum :"+/a" &#"r'a(a%$a% &alam #3++%)a #a&a la$!la$ 3l"(
li+amen#m ',$'!$)#a#im &a% #a&a #"r"m#ua% 3l"( li+amen#m
',$e)iale4 L*am"%'a % &b"%'u$ &ar a+/a #"l:/a4  -.

Ba#a)-Ba#a) /e)iae
Pa&a la$!la$
 (e an#e!i$!: +)m#(++ #ub/a, l"ma$ r"'r3#ub$, &a% &%&%* a%'"r3r 

ab&3m"%4
 (e '$)#e!i$!: :"+/a r"'r3:"+/al+ #"r'3%", &u/'u+ &""r"%+, :"+/ular 

+"m%al+, a+/a r"/'3:"+/al+, &a% r"/'um4

 (e la#e!al: & a'a+ mu+/ulu+ 3b'ura'3r %'"r%u+ &a% & baa( mu+/ulu+

l":a'3r a%4
 (e )'e!i$!: & a'a+ #"r'3%"al+, l"%*$u%* l"um, &a% /3l3% +*m3&"um4
 (e in3e!i$!: #r3+'a'a4

Pa&a #"r"m#ua%
Kar"%a '&a$ a&a #r3+'a'a, :"+/a ur%ara '"rl"'a$ l"b( r"%&a( & &alam
 #"l:+ #"r"m#ua% &ba%&%*$a &"%*a% #"l:+ la$!la$, &a% /3llum :"+/a" '"rl"'a$ 
la%*+u%* & a'a+ &a#*ra*mur3*"%'al4 Ba'a+!ba'a+ a%'ara :"+/a ur%ara &"%*a%
u'"ru+ &a :a*%a 'en#in+ di'i*i!*an di *lini*"
 (e an#e!i$!: +)m#(++ #ub/a, l"ma$ r"'r3#ub$, &a% &%&%* a%'"r3r 
ab&3m"%4
 (e '$)#e!i$!:  &#+a($a% &ar r"/'um 3l"( :a*%a

5
  (e la#e!al: & a'a+ mu+/ulu+ 3b'ura'3r %'"r%u+ &a% & baa( mu+/ulu+
l":a'3r a%4
 (e )'e!i$!: "C/a:a'3% u'"r3:"+/al+ &a /3r#u+ u'"r
 (e in3e!i$!: &a#(ra*m ur3*"%'al"4 -.

I""   Vaskularisasi

A!#e!i
Ar'"r :"+/al+ +u#"r3r &a% %"r3r, /aba%*!/aba%* ar'"ra la/a %'"r%a4 -.

/ena
V"%a!:"%a m"mb"%'u$ 'le) en$)) e)iali) , & baa( b"r(ubu%*a% &"%*a%
 #l"Cu+ #r3+'a'/u+= &a% b"rmuara $" :"%a la/a %'"r%a4 -.

Ali!an Lim3e
P"mbulu( lm" b"rmuara $" %3& la/ %'"r% &a% "C'"r%4  -.

Pe!)a!a3an
P"r+araa% :"+/a ur%ara b"ra+al &ar #l"Cu+ ()#3*a+'r/u+ %"r3r4 S"rabu'
 #3+*a%*l3%$ +m#a'$ b"ra+al &ar *a%*l3% lumbal" #"r'ama &a% $"&ua &a%
 b"r8ala% 'uru% $" :"+/a" ur%ara m"lalu #l"Cu+ ()#3*a+'r/u+4 S"rabu'
 #r"*a%*l3%$ #ara+m#a'$u+ )a%* mu%/ul +"ba*a %"r: +#la%/(%/ #"l:/ &ar
%"r:u+ +a/ral+ $"&ua, $"'*a, $""m#a', b"r8ala% m"lalu #l"Cu+ ()#3*a+'r/u+
m"%u8u $" :"+/a ur%ara, & '"m#a' % +"rabu'!+"rabu' '"r+"bu' b"r+%a#+ &"%*a%
%"ur3% #3+*a%*l3%$4 S"ba*a% b"+ar +"rabu' a"r"% +"%+3r$ )a%* b"ra+al &ar
:"+/a ur%ara m"%u8u +)+'"m +ara #u+a' m"lalu %"r: +#la%/(%/ #"l:/4
S"ba*a% +"rabu' a"r"% b"r8ala% b"+ama +ara +m#a'$ m"lalu #l"Cu+
()#3*a+'r/u+ &a% ma+u$ $" m"&ulla +#%al+ +"'%** +"*m"% lumbal+ #"r'ama
&a% $"&ua4 -.
Sara +m#a'$ m"%*(amba' $3%'ra$+ mu+/ulu+ &"'ru+3r :"+/a" &a% m"ra%*+a%*
 #"%u'u#a% mu+/ulu+ +#(%/'"r :"+/a"4 Sara #ara+m#a'$ m"ra%*+a%* $3%'ra$+
mu+/ulu+ &"'ru+3r :"+/a" &a% m"%*(amba' $"r8a mu+/ulu+ +#(%/'"r :"+/a"4 -.

6
I"D" In)iden)i
A%*$a $"8a&a% 'rauma #a&a bul!bul #a&a b"b"ra#a $l%$ ur3l3* $ura%*
l"b( 2 &ar +"luru( 'rauma #a&a ++'"m ur3*"%'ala, /"&"ra $a%&u%* $"m(
)a%* &a$ba'$a% &ar 'rauma 'um#ul 70!0 a'au 'rauma '"mbu+ 20!504 -9,;.

II.   ETIOLOGI

Trauma $a%&u%* $"m( '"rba%)a$ $ar"%a $"/"la$aa% lalu l%'a+ a'au

$"/"la$aa% $"r8a )a%* m"%)"bab$a% ra*m"% #a'a( 'ula%* #"l:+ m"%/"&"ra bul!
 bul4 -1.
Fra$'ur 'ula%* #a%**ul &a#a' m"%mbul$a% $3%'u+3 a'au ru#'ur $a%&u%*
$"m(4 Pa&a $3%'u+3 bul!bul (a%)a '"r8a& m"mar #a&a &%&%* bul!bul
&"%*a% ("ma'ura 'a%#a "$'ra:a+a+ ur%4  -1.
Kura%* l"b( 0 'rauma 'um#ul bul!bul a&ala( a$ba' ra$'ur #"l:+4
F$+a+ bul!bul #a&a 'ula%* #"l:+ 3l"( a+a "%&3#"l:$ &a% &ara*ma #"l:+
+a%*a' $ua' +"(%**a /"&"ra &"+"l"ra+ '"ru'ama 8$a ''$ $+a+ a+a b"r*"ra$ 
 #a&a ara( b"rlaa%a% -+"#"r' #a&a ra$'ur #"l:+., &a#a' m"r3b"$ bul!bul4
R3b"$%)a bul!bul $ar"%a ra$'ur #"l:+ b+a #ula '"r8a& a$ba' ra*m"% 'ula%*
 #"l:+ m"r3b"$ &%&%*%)a4 Dalam $"a&aa% #"%u( '"r+ ur%", bul!bul mu&a(
+"$al r3b"$ 8$a m"%&a#a'$a% '"$a%a% &ar luar b"ru#a b"%'ura% #a&a #"ru'
+"b"la( baa(4 Bul!bul a$a% r3b"$ #a&a &a"ra( u%&u+ &a% m"%)"bab$a%
"$'ra:a+a+ ur%" $" r3%**a %'ra#"r'3%"um4 -6.
Ru#'ur $a%&u%* $"m( &a#a' b"r+a' %'r"#"r'3%"al &a% "$'ra#"r'3%"al4
Ru#'ur $a%&u%* $"m( "$'ra#"r'3%"al ba+a%)a a$ba' '"r'u+u$ ra*m"% ra$'ur 
'ula%* #"l:+ #a&a &%&%* &"#a% $a%&u%* $"m( )a%* #"%u(4 Pa&a $"8a&a% %
'"r8a& "$'ra:a+a+ ur% & r3%**a #"r:"+$al4-1.
Trauma 'um#ul &a#a' m"%)"bab$a% ru#'ur bul!bul, '"ru'ama bla $a%&u%*
$"m( #"%u( a'au '"r&a#a' $"la%a% #a'3l3*$, +"#"r' 'ub"r/ul3++, 'um3r, a'au
3b'ru$+ +"(%**a 'rauma $"/l +u&a( m"%)"bab$a% ru#'ur4 -1.

7
 Trauma 'a8am a$ba' lu$a 'u+u$ a'au '"mba$ l"b( 8ara%* &'"mu$a%4 Lu$a
&a#a' m"lalu &a"ra( +u#ra#ub$ a'au#u% 'ra%+#"r%"al4 P"%)"bab la% a&ala(
%+'ru"%'a+ ur3l3*$4 -1.
T%&a$a% "%&3ur3l3* &a#a' m"%)"bab$a% 'rauma bul!bul a'r3*"%/ a%'ara
la% #a&a r"+"$+ bul!bul 'ra%+ur"'(ral -TUR Bul!bul. a'au #a&a l'3'r#+4
D"m$a% #ula #ar'u+ $a+"# a'au '%&a$a% 3#"ra+ & &a"ra( #"l:+ &a#a'
m"%)"bab$a% 'rauma a'r3*"%/ #a&a bul!bul4 Ru#'ura bul!bul &a#a' #ula
'"r8a& +"/ara +#3%'a%= (al % ba+a%)a '"r8a& 8$a +"b"lum%)a '"r&a#a' $"la%a%
 #a&a &%&%* bul!bul4 I%"$+ 'ub"r/ul3++, 'um3r bul!bul, a'au 3b+'ru$+
%ra:"+$al $r3%+ m"%)"bab$a% #"ruba(a% +'ru$'ur 3'3' bul!bul )a%*
m"l"ma($a% &%&%* bul!bul4 Pa&a $"a&aa% 'u b+a '"r8a& ru#'ur" bul!bul
+#3%'a%"a4-6.

Gambar 54 Ru#'ura bul!bul4 A4 I%'ra#"r'3%"al r3b"$%)a bul!bul #a&a &a"ra( u%&u+,

m"%)"bab$a% "$+'ra:a+a+ ur%" $" r3%**a %'ra#"r'3%"um4-6.4 B4 E$+'ra#"r'3%"al a$ba'
ra$'ura 'ula%* #"l:+4-6.4

III.   KLASIFIKASI

8
 S"/ara $l%+ /"&"ra bul!bul &b"&a$a% m"%8a& $3%'u+3 bul!bul, /"&"ra
 bul!bul "$+'ra#"r'3%"al, &a% /"&"ra %'ra#"r'3%"al4 Pa&a $3%'u+3 bul!bul
(a%)a '"r&a#a' m"mar #a&a &%&%*%)a, mu%*$% &&a#a'$a% ("ma'3ma
 #"r:"+$al, '"'a# '&a$ &&a#a'$a% "$'ra:a+a+ ur%" $" luar bul!bul4-6.
A&a &ua '#" ru#'ur $a%&u%* $"m(> %'ra#"r'3%"al &a% "$'ra#"'3%"al -10.
a. Ru#'ur $a%&u%* $"m( %'ra#"r'3%"al m"%)"bab$a% "$+'ra:a+a+ ur% $"
&alam r3%**a #"r'3%"um a$ba' /"&"ra #a&a $uba( $a%&u%* $"m( -a#"C
:"+/a".= $3%&+ % +"r%* m"%mbul$a% #"r'3%'+4
• "&"ra 8"%+ % +"r%* $al '"r8a& #a&a #a+"% )a%* m"%*alam
'rauma +aa' $a%&u%* $"m(%)a #"%u(4
• I%'"r:"%+ b"&a( +"r%* $al &#"rlu$a% #a&a /"&"ra % -10.

 b. Ru#'ur $a%&u%* $"m( "$'ra#"r'3%"al l"b( +"r%* &'"mu$a% $"'mba%*

ru#'ur $a%&u%* $"m( %'ra#"r'3%"al4 Ru#'ur % m"%)"bab$a% "$+'ra:a+a+
ur% a$ba' /"&"ra #a&a &%&%* la'"ral a'au &a+ar $a%&u%* $"m( -u%&u+
:"+/a". -10.
• L"+ )a%* $"/l b+a &'a%*a% 'a%#a #"mb"&a(a%, &"%*a%
 #"ma+a%*a% $a'"'"r ur% +"lama 7!10 (ar &a% a%'b3'/ #r3la$'$4
• S+'3*ra r"'r3*ra&" a'au ++'3*ram T b"r*u%a u%'u$ 
m"%*":alua+ b"rba*a /"&"ra #a&a $a%&u%* $"m(4 -10.
"&"ra %'ra#"r'3%"al m"ru#a$a% 2;!9; &ar +"luru( 'rama bul!
 bul, +"&a%*$a% $"8a&a% /"&"ra bul!bul "$+'ra#"r'3%"al $ura%* l"b( 9;!
60 &ar +"luru( 'rauma bul!bul4 T&a$ 8ara%* /"&"ra bul!bul
%'ra#"r'3%"al '"r8a& b"r+ama &"%*a% /"&"ra "$+'ra#"r'3%"al -2!12.4-6.
Pa&a /"&"ra bul!bul %'ra#"r'3%"al '"r8a& #"%*alra% ur%" $"
r3%**a #"r'3%"al +"(%**a m"%)"bab$a% %lama+ ba($a% %"$+
-#"r'3%'+.4 Ol"( $ar"%a 'u 8$a '&a$ +"*"ra &la$u$a% '%&a$a%
 #"mb"&a(a%, 10!20 /"&"ra bul!bul b"ra$ba' $"ma'a% $ar"%a +"#++4 -6.

 American association for the surgery of trauma injury score for the bladder 
m"%*$la+$a+$a% 'rauma bul!bul b"r&a+ar$a% &"ra8a' $"#ara(a%%)a -11.

9
Gra&"
I "ma'3m K3%'u+3, ("ma'3m %'ramural
La+"ra+ Par'al '(/$%"++
II La+"ra+ La+"ra+ &%&%* "C'ra#"r'3%"al  2/m
III La+"ra+ La+"ra+ "C'ra#"r'3%"al -H2. /m a'au %'ra#"r'3%"al -2/m.
IV La+"ra+ La+"ra+ &%&%* %'ra#"r'3%"al H2/m
V La+"ra+ La+"ra+ %'ra#"r'3%"al a'au "C'ra#"r'3%"al m"lua+ $"
 bla&&"r %"/$ a'au 3r/um ur"'"r -'r*3%".

I/" DIANOSIS
14 A%am%"++
S"'"la( m"%*alam /"&"ra #a&a ab&3m"% +"b"la( baa(, #a+"%
m"%*"lu( %)"r & &a"ra( +u#ra+m++, m$+ b"r/am#ur &ara( a'au
mu%*$% #a+"% '&a$ &a#a' m$+4  -6.
24 P"m"r$+aa% F+$ >
P"m"r$+aa% +$ ab&3m"% b+a &'"mu$a% &+'"%+ ab&3m"%, r"b3u%&
'"%&"r%"++4 T&a$ a&a%)a b+%* u+u+ &a% 'a%&a!'a%&a r'a+ #"r'3%"al
m"%*%&$a+$a% $"mu%*$%a% '"r8a&%)a ru#'ur bul bul %'ra#"r'3%"al4
P"m"r$+aa% r"$'al '3u/("r #"rlu &la$u$a% u%'u$ m"%)%*$r$a%
$"mu%*$%a% '"r8a&%)a /"&"ra r"$'um, &a% #a&a #ra #"rlu &la$u$a%
u%'u$ m"%*":alua+ #3++ #r3+'a'4 A#abla #r3+'a' m"%*alam (*(
r&%* a'au +"&$' "l":a+, $"/ur*aa% m"%*ara( #a&a /"&"ra ur"'(ra
 #r3$+mal )a%* &+"r'a &+ru#+ bul bul4-12.
54 P"m"r$+aa% P"%u%8a%*>-15.
Te) Bli-,li"

• Bul!bul &$3+3%*$a% &"%*a% $a'"'"r, lalu &ma+u$$a% 500 ml la ru'a%

*aram aal )a%* +"&$' m"l"b( $a#a+'a+ bul!bul4
• Ka'"'"r & $l"m +"b"%'ar, lalu &bu$a $"mbal, /ara% )a%* $"luar 
&u$ur $"mbal4 Bla +"l+(%)a /u$u# b"+ar mu%*$% '"r&a#a' ru#'ur 
 bul!bul4-15.
K"$ura%*a% &ar '"+ % ala(>

10
 a+l %"*a':" #al+u bla &a"ra( ru#'ur" '"r'u'u# b"$ua% &ara(, u+u+
a'au 3m"%'um4
a+l #3+' #al+u bla muara $a'"'"r '"rlalu '%** a'au $a'"'"r 
'"r+umba' b"$ua% &ara( +"(%**a +"l+( /ara% 'a$ b+a $"luar 
Su$ar m"mb"&a$a 8"%+ "$+'ra#"r'3%"al &"%*a% %'ra#"r'3%"al4 -15.

Radi$l$+i

URETROSISTOGRAFI
U%'u$ m"%/ar a&a%)a "$+'ra:a+a+ ur% &a% l3$a+ $"la%a%%)a
+"r'a m"mb"&a$a% 8"%+ "$+'ra#"r'3%"al &a% %'ra#"r'3%"al4-15.
P"m"r$+aa% #"%/'raa% b"ru#a ++'3*ra, )a'u &"%*a% /ara
m"ma+u$$a% $3%'ra+ $" &alam bul!bul +"ba%)a$ 500!900 ml +"/ara
*ra:'a+ -'a%#a '"$a%a%. m"lalu $a'"'"r #"r!ur"'ram4 K"mu&a% &bua'
 b"b"ra#a 3'3, )a'u -1. 3'3 #a&a +aa' bul!bul '"r+ $3%'ra+ &alam #3++
a%'"r3r!#3+'"r3r -AP., -2. #a&a #3++ 3bl$, &a% -5. a+( 3u' lm )a'u
3'3 +"'"la( $3%'ra+ &$"luar$a% &ar bul!bul4 J$a &&a#a'$a% r3b"$a%
 #a&a bul!bul, '"r&a#a' "$+'ra:a+a+ $3%'ra+ & &alam r3%**a #"r:"+$al
)a%* m"ru#a$a% 'a%&a a&a%)a r3b"$a% "$+'ra#"r'3%"al, -6.  a$a% %am#a$ 
*ambara% "$'ra:a+a+ '"rl(a' +"#"r' %)ala a# #a&a &a"ra( #"r:"+$al,-1.4
J$a '"r&a#a' $3%'ra+ )a%* b"ra&a & +"la!+"la u+u+,-6.  &a% a'au '"rl(a'
$3%'ra+ ma+u$ $" r3%**a ab&3m"%,-1. b"rar' a&a r3b"$a% bul!bul
%'ra#"r'3%"al

Gambara% %3rmal > K"la%a% &'"mu$a%

11
 B A 

a4 )+'3*ram4 E$+'ra:a+a+ $3%'ra+ +"#a%8a%* a+#"$ la'"ral &a% %"r3r 

$a%&u%* $"m( -#a%a( a'a+. )a%* &+"r'a &"%*a% ra$'ur #"l:+ -#a%a(. -19.
 b4 E$+'ra:a+a+ $3%'ra+ '"rl(a' ma+u$ $" &alam #"r'3%"um m"mb"r *ambara%
l33#!l33# u+u+4
/4 m"%u%8u$$a% ru#'ur bul bul "$+'ra#"r'3%"al &"%*a% "C'ra:a+a+ $" +/r3'um
-&"%+" lam" +(a#"&.

USG
USG m"ru#a$a% +ala( +a'u #"m"r$+aa% #"%u%8a%* ra&3l3*+ )a%*
r"la':" ama%, $ar"%a USG '&a$ m"%**u%a$a% +%ar ra&3a$' u%'u$ 
+ara%a ma*%* %)a, %amu% m"%**u%a$a% *"l3mba%* +uara r"$u"%+

12
 '%**  ul'ra+3%/ -1!10M.4 S"la% 'u, #"m"r$+aa% USG 8u*a m"ml$
 b"b"ra#a $"l"b(a%, a%'ara la% > l"b( /"#a', '&a$ #"rlu #"r+a#a% $(u+u+
-(a%)a +a8a #a+"% &m%'a u%'u$ ba%)a$ m%um &a% m"%a(a% BAK 
+"(%**a VU '"r&+'"%+., ama%, %3% %:a+:" &a% '&a$ +a$', l"$+b"l &a%
r"la':" l"b( mura(4 S"la% 'u, USG 8u*a m"ml$ $"l"ma(a%, a%'ara la%
> $"+ul'a% #a&a 3ra%* *"mu$ $ar"%a 8ar%*a% l"ma$ )a%* '"bal
m"%)"bab$a% ba+ #a&a ma*%*, USG '&a$ &a#a' m"%/'ra$a% 3r*a%
)a%* b"r+ u&ara &a% 3r*a% )a%* '"r'u'u# 3l"( 'ula%* & &"#a%%)a, USG
'&a$ &a#a' m"%la u%*+ +ua'u 3r*a% -1;.
Gambara% N3rmal >

K"la%a% )a%* &'"mu$a% >

V"+/a Ur%ara > D%&%* m"%"bal &"%*a% #"rmu$aa% $"+a% rr"*ular4

Tam#a$ "/(3 +lu&*" )a%* ba%)a$ & &alam%)a
Tam#a$ "/(3 /ara% b"ba+ m%mal #a&a r"+"+u+ ("#a'3r"%al+
(e)an : ara% b"ba+ m%mal %'ra#"r'3%"um

13
P"%"bala% &%&%* :"+/a ur%ara &"%*a% Slu&*" )a%* ba%)a$ & &alam%)a

T ! UROGRAFI
T ur3*ra a&ala( #"m"r$+aa% T +/a% +"b"lum &a% +"+u&a( #"mb"ra%
$3%'ra+ %'ra:"%a u%'u$ m"%am#la% *ambara% 'ra$'u+ ur%aru+4 -16.

Tu8ua% P"m"r$+aa%>
1. Untuk menilai fungsi ginjal, ureter dan vesika urinaria
2. U%'u$ m"%*":alua+ $a+u+ $3l$ *%8al a'au#u% ur"'"r 
3. M"%la &a% m"%*":alua+ $"la%a% +"#"r' 'um3r &a% ba'u & TU, 'rauma
+"r'a b"rba*a $"la%a% /3%*"%'al
4. P"r+a#a% u%'u$ 'ra%+#a%'a+ *%8al

T Ur3*ram T"rba* &ua /ara >

14 T ur3*ram 'a%#a $3%'ra+ >
 P"r+a#a% l"b( mu&a(
 Ba)a l"b( mura(
 P"m"r$+aa% l"b( /"#a'
 A$ura+ u%'u$ $a+u+ %"r3l'a++ +u&a( /u$u#

24 T Ur3*ram D"%*a% K3%'ra+

• L"b( a$ura' u%'u$ m"%la u%*+ "$+$r"+ &a% +"$r"+ &ar 'ra$'u+ Ur%aru+

• B+a & r"$3%+'ru$+ &"%*a% b"rma/am '"$%$ 

P"r+a#a% Pa+"%

14 Pua+a ma$a% #a&a' +"lama 6 8am

24 Sa'u Jam +"b"lum #"m"r$+aa%, #a+"% m%um ar #u'( +"ba%)a$ ;00!
600 // +"r'a m"%a(a% u%'u$ '&a$ BAK 
54 P"%*ambla% &ara( u%'u$ #"m"r$+aa% ur"um/r"a'%%4

14
 94 P"m"r$+aa% &mula a#abla #a+"% +u&a( %*% BAK4

P3++ &a% Pr3+"&ur P"m"r$+aa%

Su#%", F""' r+'

Gambara% (&r3%"r3++ &"%*a% #3'3%*a% ACal &a% 3r3%al #a&a T Ur3*ram 'a%#a
$3%'ra+

Gambara% (&r3%"r3++ &a% (&r3ur"'"r )a%* &+"bab$a% 3l"( ba'u 3#a$ & ur"'"r3:"+$3 8u%/'3%
 #a&a #3'3%*a% ACal &a% 3r3%al T Ur3*ram 'a%#a $3%'ra+

15
Gambara% Ta$'u+ ur%aru+ &"%*a% '"$%$ MIP #a&a a+" D"la)"&, S"r'a MPR T(% #a&a a+"
V"%3u+

Gambara% V3lum" R"%&"r%* -VRT. #a&a T Ur3*ram &"%*a% $3%'ra+ Fa+" E$+$r"+

$a%&u%* $"m( #"/a( ba+a%)a '"rl(a' &alam $3%'"$+ 'rauma +*%$a%4

Kla+$a+

$a%&u%* $"m( #"/a( &a#a' &$a'"*3r$a% $" &alam lma 8"%+, '"r*a%'u%* #a&a
l3$a+ &a% lua+%)a #"/a(4

14 $a%&u%* $"m( m"mar 

% +"r%* '"rl(a' 'a# $a&a%*!$a&a%* '&a$ &*3l3%*$a% +"ba*a #"/a( b"%ar,
$ar"%a m"lba'$a% '&a$ l"%*$a# m"r3b"$ &ar mu$3+a4

24 P"/a(%)a +ub+"r3+a

Ju*a &$"%al +"ba*a #"/a( %'"r+''al, % 8ara%* '"r8a&4 al % &+"bab$a% 3l"(
ar ma'a & #"rmu$aa% +"r3+a4

54 I%'ra#"r'3%"al $a%&u%* $"m( #"/a(

16
T"r8a& & +"$'ar  1; -$+ara% 10!20. &ar /"&"ra $a%&u%* $"m( u'ama, &a%
 ba+a%)a m"ru#a$a% (a+l &ar #u$ula% la%*+u%* $" $a%&u%* $"m( +u&a( bu%/'4
)+'3*ra#() m"%u%8u$$a% ba(a% $3%'ra+ %'ra#"r'3%"al +"$'ar l33# u+u+, a%'ara
l#a'a% m"+"%'"r$a &a% & +"l3$a% #ara/3l/4 P"%*3ba'a% #"mb"&a(a%4

94 E$+'ra#"r'3%"al $a%&u%* $"m( #"/a(

"$+'ra#"r'3%"al #"/a( a&ala( 8"%+ )a%* #al%* umum

&ar$a%&u%*/"&"ra$"m(,a$u%'a%+ u%'u$  ; -$+ara% 0!0. $a+u+4 I%
 ba+a%)a m"ru#a$a% (a+l &ar #a'a( 'ula%* #a%**ul a'au 'rauma #"%"'ra+4
)+'3*ra#() m"%*u%*$a#$a% 8alur :arab"l ba(a% $3%'ra+ "C'ra:a+a'"&4
P"%*3ba'a% &"%*a% $a'"'"r -ID  F3l").4

;4 Gabu%*a% $a%&u%* $"m( #"/a(

Smul'a% %'ra#"r'3%"al &a% /"&"ra "$+'ra#"r'3%"al4 )+'3*ra#() ba+a%)a

m"%u%8u$$a% #3la "$+'ra:a+a+ )a%* $(a+ u%'u$ $"&ua 8"%+ /"&"ra4

Ra&3*ra 'ur 

 #"%)"l&$a% Tra&+3%al u%'u$ '"r+a%*$a ru#'ur $a%&u%* $"m( &"%*a% &la$u$a%

&"%*a% lu3r3+$3# /)+'3*ra#() 54 Namu%, $ar"%a % a&ala( m"ma$a% a$'u &a%
'&a$ &a#a' m"%*$ara$'"r+a+ +'ru$'ur #a%**ul la%%)a #"%**u%aa%%)a +"&a%*
+"/ara b"r'a(a# &*a%'$a% 3l"( T /)+'3*ra#()4

T

T /)+'3*ra#()&la$u$a% &"%*a% m"%a%am$a% ar $3%'ra+ laru' $" &alam

$a%&u%* $"m( m"lalu $a'"'"r F3l")4 I% &a#a' &$3mb%a+$a% &"%*a% +'a%&ar 
T u%'u$ m"%*":alua+ +alura% a'a+/"&"ra4

P"%am#la% b"r:ara+ &"%*a% l3$a+

17
 ● Trauma $a%&u%* $"m(

o )a%* %3rmal

● +ub+"r3+a #"/a(

o "$+'ra:a+a+ "l#'/al $3%'ra+ +"$'ar $a%&u%* $"m(

● %'ra#"r'3%"al

o  ba+a%)a$a%&u%* $"m( $uba( #"/a(

o $3%'ra+& +"l3$a% #ara/3l/ &a% a%'ara l33# &aru+u+ $"/l

● "$+'ra#"r'3%"al

o  ba+a%)a & &a+ar $a%&u%* $"m( a%'"r3la'"rall)

o "$+'ralum%al $3%'ra+ $" rua%* a%*$a+a #"r:"+/al

-+"&"r(a%a.

o m3lar'a%&a **

o  #"r#a%8a%*a%$3%'ra+ "$+'ralum%al $" #a(a, +$r3'um a'au

 #"r%"um -$3m#l"$+.

● *abu%*a%

o 'ur /am#ura% %'ra#"r'3%"al &a%#"/a( "$+'ra#"r'3%"al

P"%*3ba'a%&a% #r3*%3++

 #"/a( %'ra#"r'3%"al m"mbu'u($a% b"&a( #"rba$a% +"m"%'ara /"&"ra "$+'ra!

 #"r'3%"al )a%* &#"rla$u$a% +"/ara $3%+"r:a' &"%*a% $a'"'"r $a%&u%* $"m(4
K"(a&ra% /"&"ra +alura% *%8al la% )a%* m"lba'$a% ur"'"r a'au ur"'ra mu%*$%
m"m"rlu$a% %'"r:"%+ '"r#+a(

)+'3*ra#() a&ala( +'u& lu3r3+$3#$ *ambar $a%&u%* $"m(4 al % mr#
&"%*a% :3&%*/)+'3ur"'(r3*ram-VUG.,&a% #"rb"&aa% $"&ua%)a )a'u
/)+'3*ram b"r3$u+ #a&a $a%&u%*$"m( &a% VUG +"bua( b"r3$u+ #a&a
ur"'ra #3+'"r3r4

I%&$a+

18
 ● &+u%*+3%al b"r$"m(
● $a%&u%* $"m( 3b+'ru$+
● ("ma'ura
● 'rauma
● a%3mal $3%*"%'al #a&a +alura% ur3*"%'al
● ":alua+ #a+/a 3#"ra+ &ar +alura% $"m(

Pr3+"&ur 

T"$%$ 

● m"ma+u$$a% $a'"'"r F3l") & $a%&u%* $"m(, a'au

m"%**u%a$a% b"r&am%)a F3l") a'au $a'"'"r +u#ra#ub$ 
● m"m#"r$"%al$a% $3%'ra+ laru' ar m"lalu $a'"'"r -+"#"r'
I+3:u"!500 a'au )+'3*ra%.
●  8$a m"%/ar $"b3/3ra% $a%&u%* $"m( +"'"la( 'rauma,
m"%*+ $3%'ra$+ &"'ru+3r a'au +"'&a$%)a 500 ml
●  8$a m"%/ar #a+/a 3#"ra+ a'au /"&"ra, + &"%*a% :3lum"
)a%* l"b( $"/l - 100!1;0 ml. a'au +am#a r"++'"%+ &ra+a$a%
○ m"%*(%&ar #"%*+a% b"rl"b(, a*ar '&a$
m"%u# +"bua( 8a('a% a%a+'3m3'/
● u%'u$ m"%/3ba u%'u$ m"ma+'$a% $3%'ra$+ &"+'ru+3r,
m"%/3ba u%'u$ m"ml$ $"$3+3%*a% #a+"%, 8$a m"mu%*$%$a%4

 #r3)"$+ b"r$u' (aru+ &#"r3l"( m"%8a*a &alam #r%+#

14 AP #ramu$a ma*"
24 ALARA>4AP aal m"%*+ *ambar -8$a /"&"ra a'au
":alua+ #a+/a 3#"ra+, 3$u+ #a&a b&a%*!b&a%*.
54 AP &a% 3blu"+ /uram $a%&u%* $"m( -m"%/3ba u%'u$
m"ma+u$$a% la)a( ma%a UVJ a$a% m"%8a&.4
94  #3+':3& ra&3*ra 

&3ubl" $3%'ra+ /)+'3*ra#() -#%"um3/)+'3*ra#().  :ara+ #a&a /)+'3*ram +'a%&ar

mu%*$%, 'a# +a%*a' 8ara%* &la$u$a%4

19
P"ru' 'a%&a ** m3lar m"%*a/u #a&a #"%am#la% m"&a $3%'ra+ +#lll"& $"luar 
&ar $a%&u%* $"m( #a&a T /)+'3*ra#() +"'"la( #"/a( $a%&u%* $"m(
"$+'ra#"r'3%"al4

K3%'ra+ m"%*alr $"luar &ar $a%&u%* $"m( )a%* #"/a(, m"%"m#a'

 #r"#"r'3%"al /a:um R"' &a% m"%*"ll%* $a%&u%* $"m( &alam b"%'u$ **
m3lar4

'a%&a ** m3lar m"%*a/u #a&a #"%am#la% 3'a$ '"%*a( & ba*a% a$+al )a%*
m"ma%8a%*  #"&u%/l"+ +"r"b"lum +u#"r3r  m"mb"r$a% 3'a$ '"%*a(  #"%am#la%
m"%*%*a'$a% ** m3lar4

I% #"r'ama $al &'"mu$a% #a&a +%&r3m J3ub"r' &a% '"r$a' *a%**ua% -JSRD.
2,'"'a# +"$ara%* &a$u '"r8a& & +"8umla( $3%&+ la%, m+al%)a
%"#(r3%3#('++,br3++ (a' &a% +%&r3m 3*a%%4

USG &ar $a%&u%* $"m( !Pr3'3$3l

P"ra% USG
USG a&ala( ala' #"%'%* u%'u$ m"%la &%&%* $a%&u%* $"m( u%'u$ #"%"bala%
&%&%*, 'rab"/ula'3%, ma++a &a% &:"r'/ula"4 V3lum" b"r$"m( #ra &a% #a+/a4
P"r+m#a%*a% :"+$3!ur"'"r 8u*a &a#a' &:+ual+a+$a%4 Ka%&u%* $"m( ba'" 
 b"%&a a+%*4 Gu%a$a% $a%&u%* $"m( #"%u( +"ba*a 8"%&"la a$u+'$ u%'u$ 
m"%la #r3+'a' #a&a la$!la$ &a% +'ru$'ur *%"$3l3* #a&a a%'a4

K"'"rba'a+a%
lua+ 8ar%*a% #aru' #a%**ul a'au *a+ u+u+ 3:"rl))%* a$a% m"mbua' m"m%&a
$a%&u%* $"m( +ul'4
J$a $a%&u%* $"m( '&a$ /u$u# bu%/', #a'3l3* mu%*$% '"r+"mbu%) 3l"(
l#a'a%

S"l"$+4P"rala'a%
P"%**u%aa% #r3b" l"%*$u%* -5!;MQ. &"%*a% &3##l"r ar%a4

20
P"r+a#a% #a+"%
 #a+"% (aru+ (a&r &"%*a% $a%&u%* $"m( #"%u(4
2(r+ +"b"lum #"%*a%*$a'a%, #a+"% (aru+ m"%*3+3%*$a% $a%&u%* $"m( m"r"$a4
S"lama +a'u 8am b"r$u'%)a m"r"$a (aru+ m%um +"'&a$%)a 1 l'"r ar4 al %
m"mu%*$%$a% a$'u u%'u$ ar u%'u$ m"%/a#a $a%&u%* $"m(4
Ja%*a% #"r* $" '3l"' +am#a &#"r%'a($a% 3l"( +3%3*ram4

S/a%%%* T"$%$ 

'"rl"%'a%* Pa+"% &"%*a% &a"ra( +u#ra#ub$ '"r$"%a4

P"r$+a $a%&u%* $"m( +a*''all) & *ar+ '"%*a(4 S"$ara%* +u&u' la'"ral 
m"%)a#u #r3b" ba$ $r &a% $a%a% u%'u$ m"m"r$+a mar*% la'"ral4
Pu'ar 0&"*r""+ $" &alam #"+aa' a$+al -'ra%+:"r+al.4 M"%)a#u &ar $uba(
u%**ul &a+ar $a%&u%* $"m(4 Pa+'$a% bal3$ USG &#r3)"$+$a% +"ba*a &"$a'
&"%*a% '"*a$ luru+ '"r(a&a# &%&%* $a%&u%* $"m( mu%*$%4
arla( 8"' ur"'"r & &a+ar $a%&u%* $"m(4 I% m"%"*a+$a% u%*+ *%8al bla'"ral
&a% ur"'"r #a'"%+4 U%'u$ m"la$u$a% (al %, & +u&u' m"l%'a%* %"r3r 
m"%**u%a$a% '"%a*a &3##l"r -a'au &3##l"r ar%a &"%*a% #"%*a'ura% PRF 
Fl'"r '"mb3$ r"%&a(.4 A%&a mu%*$% #"rlu b"r+abar u%'u$ m"%u%**u 8"' ur"'"r 
'"r*a%'u%* #a&a u%*+ *%8al &a% '%*$a' (&ra+4
D3$um"% a%a'3m %3rmal &a% #a'3l3* m"%"mu$a% -'"rma+u$ #"%*u$ura% &a%
:a+$ular+a+ 8$a &%&$a+$a%.4 M"%*u$ur #ra V3lum" $a%&u%* $"m( &a%
 #3+'%* b"r$"m(4 S"ba*a a'ura% #ra$'+, $a%&u%* $"m( (aru+ $3+3%* +"$'ar 
10 &ar :3lum" #ra!b"r$"m(4 J$a aal V3lum" #a+/a $"$3+3%*a% l"b( b"+ar 
&ar 100mL, m"%&3r3%* #a+"% u%'u$ m"%/3ba la* $ar"%a :3lum" r"+&ual b"+ar 
mu%*$% ar'"a$ +"'"la( $a%&u%* $"m( +a%*a' #"%u(4

21
 /" TERAPI
Bla #"%&"r'a &a'a%* &alam $"a&aa% +)3$, (aru+ &a'a+ &"%*a% #"mb"ra%
/ara% %'ra:"%a a'au &ara(4 Bla ++$ula+ '"la( +'abl, baru &la$u$a% r"#ara+
 bul!bul4-1.
Pr%+# #"mul(a% ru#'ur $a%&u%* $"m( ala( #"%)alra% rua%* #r":"+$al,
 #"mul(a% &%&%*, #"%)alra% $a%&u%* $"m( &a% #r":"+$al, &a% 8am%a% aru+
ur% m"lalu $a'"'"r4-1.
T"ra# /"&"ra bul!bul '"r*a%'u%* #a&a 8"%+ /"&"ra, & a%'ara%)a a&ala(> -6.
14 Pa&a $3%'u+3 bul!bul, /u$u# &la$u$a% #"ma+a%*a% $a'"'"r &"%*a%
'u8ua% u%'u$ m"mb"r$a% +'ra(a' #a&a bul!bul4 D"%*a% /ara %
&(ara#$a% bul!bul +"mbu( +"'"la( 7!10 (ar4
24 Pa&a /"&"ra %'ra#"r'3%"al (aru+ &la$u$a% "$+#l3ra+ la#ar3'3m u%'u$ 
m"%/ar r3b"$a% #a&a bul!bul +"r'a $"mu%*$%a% /"&"ra #a&a 3r*a%
la%4 J$a '&a$ +"*"ra &3#"ra+ "$+'ra:a+a+ ur%" $" r3%**a
%'ra#"r'3%"um &a#a' m"%)"bab$a% #"r'3%'+4 R3%**a
%'ra#"r'3%"um &/u/, r3b"$a% #a&a bul!bul &8a(' 2 la#+, $"mu&a%
&#a+a%* $a'"'"r ++'3+'3m )a%* &l"a'$a% & luar +a)a'a% la#ar3'3m4
54 Pa&a /"&"ra "$+'ra#"r'3%"al, r3b"$a% )a%* +"&"r(a%a -"$+'ra:a+a+
m%mal. &a%8ur$a% u%'u$ m"ma+a%* $a'"'"r 7!10 (ar, '"'a# +"ba*a%

22
 a(l la% m"%*a%8ur$a% u%'u$ m"la$u$a% #"%8a('a% bul!bul &"%*a%
 #"ma+a%*a% $a'"'"r ++'3+'3m4 Ta%#a &la$ua$a% #"mb"&a(a%,
$"8a&a% $"*a*ala% #"%)"mbu(a% lu$a  1;, &a% $"mu%*$%a% u%'u$ 
'"r8a&%)a %"$+ #a&a r3%**a #"r:"+$a +"b"+ar 124 Ol"( $ar"%a 'u
 8$a b"r+amaa% &"%*a% ru#'ur bul!bul '"r&a#a' /"&"ra 3r*a% la% )a%*
m"mbu'u($a% 3#"ra+, +"ba$%)a &la$u$a% #"%8a('a% bul!bul &a%
 #"ma+a%*a% $a'"'"r ++'3+'3m4-6.

/I" Ta%a'an Pena#ala*)anaan

14 P"mb"&a(a% +"'"la( $"a&aa% umum m"mba$, u%'u$ % &a#a' &'u%&a

+am#a 29 8am4
24 P"r(a'$a% #ula $"mu%*$%a% #a'a( 'ula%* #"l:+4
54 T"$%$ 3#"ra+>
• A%a+'"+

• I%++ m"&a%a &ar #u+a' +am#a 1 8ar & a'a+ +m++4

• A#3%"ur3++ &#3'3%* &a% m4 r"/'u+ ab&3m%+ &#+a($a% +"/ara

'um#ul4
• Bla a&a ru#'ur" bul!bul "$+'ra#"r'3%"al ma$a +"*"ra '"rl(a'
&ara( &a% ur%4
• S"'"la( &b"r+($a% a$a% 'am#a$ ba*a% a%'"r3#3+'"r3r bul!bul
&a% #"rl"$a'a%%)a &"%*a% #"r'3%"um
• Dbua' %++ $"/l & #"r'3%"um #a&a #u%/a$ bul!bul u%'u$ 
m"m"r$+a a&a%)a &ara( &a% ur% &alam r3%**a #"ru'
Bla '&a$ a&a, +"*"ra 'u'u# la* &a% #"rba$ ru#'ura
"$+'ra#"r'3%"al )a%* a&a4 Bla a&a, m"%a%&a$a% a&a%)a
ru#'ura %'ra#"r'3%"al, %++ #"r'3%"um +"*"ra &#"rl"bar 
&a% &ara( +"r'a ur% &b"r+($a%4
• Ru#'ura %'ra#"r'3%"al &#"rba$ l"b( &a(ulu &"%*a%>

23
 S"'"la( m"mb"r+($a% r3%**a #"ru', u+u+ &a% l"ma$ 
 #r":"+$al &++($a% $" a'a+= bla #"rlu #3++ #"%&"r'a
&bua' Tr"%&"l"%bur* r%*a%4 Bul!bul &a#a' &'a%&a
&"%*a% b"%'u$ 3'3' &a% #"mbulu( :"%a )a%* b"+ar!b"+ar &
&%&%*%)a4 Dbua' %++ m"%"mbu+ bul!bul & &a"ra(
+u#ra#ub$, lalu &"%*a% '"lu%8u$ )a%* &ma+u$$a%
&la$u$a% "$+#l3ra+ +"luru( bul!bul4 T"lu%8u$ '"r+"bu'
&a#a' +"$al*u+ b"ru%*+ +"ba*a r"'ra/'3r u%'u$ 
m"%am#l$a% &a"ra( ru#'ur" $" la#a%*a% 3#"ra+4 Ba*a%
)a%* ru#'ur &8a(' &"%*a% /a'*u' N34 1 &"%*a% m"%"mbu+
+"luru( la#+a% 3'3' bul!bul, 'a$ #"rlu la#+ &"m la#+4
P"r(a'$a% a*ar 8a%*a% +am#a 8arum m"%"mbu+ mu$3+a4
K"mu&a% &#a+a%* $a'"'"r F3l") m"lalu %++ +u#ra#ub$ 
'a&4 S"$'ar%)a &8a(' +"&"m$a% +"(%**a $a'"'"r 
'"r$+a+ &"%*a ba$ &a% bla %a%'%)a &/abu' ++a lu$a
 #a&a bul!bul &a#a' m"%u'u# +"%&r4 -bla (a%)a a&a
ru#'ura "$+'ra#"r'3%"al, #"ma+a*a% $a'"'"r '"'a# (aru+
m"lalu %++ )a%* &bua' baru &a% &a"ra( ru#'ur" & 8a('.4
• S"'"la( 'u baru ru#'ura "$+'ra#"r'3%"al &/ar &a% &8a(' &"%*a%
/ara )a%* +ama ba+a%)a ru#'ura '"r8a& & ba*a% a%'"r3r &"%*a%
 #r3+'a'4
• Bla #"rlu &a#a' &#a+a%* drain #r":"+$al4

• Lu$a 3#"ra+ &'u'u# la#+ &"m la#+4 -15.

Pa+/a b"&a(>
• Pa&a ru#'ura bul!bul %'ra:"+$al, +"*"ra +"'"la( +)3$ '"ra'a+
 b"ra%*+u%*!a%*+ur uba( #3++ #"%&"r'a m"%8a& #"%&"r'a
m"%8a& F3l"r4
• P"r'a(a%$a% $"+"mba%*a% /ara% &a% "l"$'r3l'4

• A%'b3'$a &3++ '%**4

• P"r(a'$a% #a'a( 'ula%* #"l:+4 -15.

24
 J$a a(l 3r'3#"& m"ma+a%* #la' u%'u$ m"m#"rba$ ra$'ur #"l:+,
mu'la$ (aru+ &la$u$a% #"%8a('a% bul!bul *u%a m"%*(%&ar '"r8a&%)a
 #"%*alra% ur%" $" ra*m"% 'ula%* )a%* '"la( &3#"ra+4 U%'u$ m"ma+'$a%
 ba(a bul!bul '"la( +"mbu(, +"b"lum m"l"#a+ $a'"'"r ur"'ra a'au $a'"'"r 
++'3+'3m, '"rl"b( &a(ulu &la$u$a% #"m"r$+aa% ++'3*ra *u%a m"l(a'
$"mu%*$%a% ma+( a&a%)a "$+'ra:a+a+ ur%"4 S+'3*ra &bua' #a&a (ar $"!10!
19 #a+/a 'rauma4 J$a ma+( a&a "$+'ra:a+a+ $a'"'"r ++'3+'3m &#"r'a(a%$a%
+am#a 5 m%**u4 -6.

/II" PEN7ULIT
Pa&a /"&"ra bul!bul "$+'ra#"r'3%"al, "$+'ra:a+a+ ur%" $" r3%**a #"l:+
)a%* &bar$a% &alam a$'u lama &a#a' m"%)"bab$a% %"$+ &a% ab+"+ #"l:+4
a%* l"b( b"ra' la* a&ala( r3b"$a% bul!bul %'ra#"r'3%"al, 8$a '&a$ +"*"ra
&la$u$a% 3#"ra+, &a#a' m"%mbul$a% #"r'3%'+ a$ba' "$+'ra:a+a+ ur%" #a&a
r3%**a %'ra #"r'3%"um4 K"&ua $"a&aa% 'u &a#a' m"%)"bab$a% +"#++ )a%* &a#a'
m"%*a%/am 8a4 Ka&a%*!$a&a%* 'u &a#a' m"%)"bab$a% +"#++ )a%* &a#a'
m"%*a%/am 8a4 Ka&a%*!$a&a%* &a#a' #ula '"r8a& #"%)ul' b"ru#a $"lu(a%
m$+, )a'u r"$u"%+ &a% ur*"%+ )a%* ba+a%)a a$a% +"mbu( +"b"lum 2 bula%4 -6.

25
 DA4TAR PUSTA(A
14 D" J3%*4  Buku Ajar Ilmu Bedah Edisi Ketiga4 Ja$ar'a, P"%"rb' Bu$u
K"&3$'"ra% EG, 2019= 9!;4
24 S3"mar$3, M4 Trauma Tumpul Abdomen4 O%l%" 2009 /'"&  O/' 2016=
A:alabl" r3m>
(''#>8$b4ub4a/4&%&"C4#(#8$bar'/l":"25;227
54 F3C, J4 (r+'a%, Clinial Emergency Radiology4 ambr&*"= 256, 254
94 S3'3, J3r*" A4 Emergency RadiologyI 4 El+":"r= 105!1094
;4 Ra+a&, S8a(rar4  Radiologi !iagnostik Edisi Kedua4 Ja$ar'a, Bala P"%"rb'
FK UI, 2010= 5054
64 Pur%3m3, B4 Ba+u$4  !asar"!asar #rologi Edisi Ketiga4 Ja$ar'a, Sa*u%*
S"'3, 2019= 15!19, 19!174
74 W"b"r, E&ar& 4 $etter Interactie Atlas %f &uman Anatomy4 El+":"r= 5974
'( Paul+"%, F4 )obotta Atlas Anatomi *anusia Edisi +, -Ilid + 4 Ja$ar'a, P"%"rb'
Bu$u K"&3$'"ra% EG, 2015= 17
4 S%"ll"%, R/(ar& S4  Anatomi Klinis Berdasarkan )ystem4 Ja$ar'a, P"%"rb'
Bu$u K"&3$'"ra% EG, 2019= 7;!7694
104 Va&am"/um4  Kedokteran Emergensi4 Ja$ar'a, P"%"rb' Bu$u K"&3$'"ra%
EG= ;2;4

26
114 Sa%'u//, R/a(r& A, M/a%%/(, Ja$ W4 Bla&&"r I%8ur"+> E:alua'3% a%&
Ma%a*"m"%'4 V3l 26-9.4 Brala% J3ur%al 3 Ur3l3*)4 2000>90!194
124 Pur%3m3 BB4 Da+ar Da+ar Ur3l3*4 2 "&4 Mala%*> Sa*u%* S"'3= 20054
.,( Pura&a%'3, A*u+4  Kedaruratan *edik Edisi Reisi /edoman
 /enatalaksanaan /raktis4 Kar+ma, 200= 1;2!1;;4
.0( Ol&"r, R3b"r' A4 Teaching Atlas of #rologic Imaging 4 T("m"= 207!2114
.1( P"m"r$+aa% Ra&3l3* Tra$'u+ Ur%aru+, &r4 T'$ ula+'u', S#4Ra&4
Ima*%* Trauma Tra$'u+ Ur%aru+, &r4 Bamba%* Sa'3'3, S#4Ra&-K.
16. Ra&3*ra"r I%3, /emeriksaan radiology CT )can urogram O%l%" 201;
'"& 16 3$' 2016 = A:alabl" r3m
(''#>4ra&3*ra"r4%3#"m"r$+aa%!ra&3l3*)!/'!+/a%!ur3*ram

27