Morning Case Report

Sunday, July 10th 2022

Oral & Maxillofacial Surgery Department
Hasan Sadikin General Hospital
Bandung
 Total Operation Total Emergency Total Follow Up
No Room patient patient Patient
1. Kemuning III 1 4 patients 1 patient 1 patient
2. Kemuning IV 2
3. Fresia I 1
4. Fresia III 1
5. RIK IV 2

TOTAL (8)
 Operation Monday, July 11th 2022
No Supervisor Operation
1. Asri Arumsari, drg., Sp.BM(K) • Plan to perform Odontectomy of
tooth 18
• Plan to perform Odontectomy of
supernumerary teeth at 12-11 and
11-21 regions

2. Seto Adiantoro, drg. Sp.BM(K) • Plan to perform Mouth preparation

• Plan to perform right
Hemimandibulectomy
PRE OP
1. Abdilah Abqari Agam/Boy/4 y.o/0001711325/22120472/Kemuning IV (3.2)
Date of Admission : 08/07/2022 Cell Phone No : 085294066165
Pre Op
Supervisor : Seto Adiantoro, drg., Sp.BM(K); Dentakusuma, drg. Sp.KGA

A 4 years old boy patient came with his mother, with complain of tooth cavities.
The patient was diagnosed with epilepsy since 2018. +/- 2 weeks prior to
admission the patient had his teeth examined at Hasan Sadikin General Hospital
pedodontics outpatient clinic, and several cavities was found, that needed to be
filled and extracted, then he went to Hasan Sadikin General Hospital OMFS dept,
for further examination and preparing for treatment under general anesthesia on
Monday (11/07/22). History to the dentist (-), drug and food allergies are denied.
history of regular drug consumption (+) valproate acid 2.5 mg 2x1 day. Operation
history (+) VP Shunt October 2018 at Hasan Sadikin General Hospital and Hernia
surgery January 2019 at Hasan Sadikin General Hospital.
• Diagnose : Multiple caries + Hydrocephalus post VP shunt +
Epilepsy + Cerebral palsy quadriplegic spastic type + Thoracic
vertebrae scoliosis + Severe malnutrition + Short stature
• Treatment : Plan to perform Mouth preparation join op. Pedodontic
department/Operation on Monday, July 11th 2022 at
COT 310(I)
• Ass Op. I  : Niken Laksmitarani, drg.
• Ass Op. II : Timotius A. Kadrianto, drg.
• Objective :
Date 08/07/22 09/07/22 10/07/22

P
102 100 101
(x/minute)

R
22 21 22
(x/minute)
T
36.5 36.6 36.5
(°C)
Laboratory
Finding
HEMATOLOGY 08/07/22
Antigen Test Negative
Laboratory
Finding HEMATOLOGY 21/06/22 09/07/22
Hb 10.2 10.7
Ht 33.4 36.0
WBC 9.21 8.96
RBC 3.91 4.13
Platelet 189,000 247,000
PT 15.0
APTT 30.40
INR 1.06
Timely Glucose 104 86
SGOT 22 15
SGPT 8 5
Ureum 29.6 21.4
Creatinine 0.35 0.21
Natrium 140 140
Kalium 3.9 4.2
Profile Photo
Intra Oral
 Chest X-Ray
(Hasan Sadikin General Hospital, July 08th 2022)
2. Rini Darwati/F/28 y.o/0001217604/22120471/Kemuning III (7.6)
Date of Admission : 08/07/2022 Cell Phone No : 087707444112
Pre Op
Supervisor : Seto Adiantoro, drg., Sp.BM(K)
A 28 years old female patient came with a complaint of a lump at her right lower jaw.
-/+ 5 years prior to admission she complained of a marble-sized, hard, firm
consistency lump, didn’t bleed easily and the color was similar to the surrounding
tissue, but the patient didn’t seek any treatment. +/- 5 months prior to admission the
patient complained the lump was getting bigger to a size of a chicken egg, painless,
hard consistency. Then the patient went to the public hospital at Sumedang area, then
was performed panoramic x-ray and was referred to Hasan Sadikin General Hospital
for biopsy with result of osteoma at right lower jaw, then the patient was scheduled for
surgery at Monday (11/07/22). History of weight loss (-), history of allergies (-),
history of systemic pain (-), history of head tumor surgery in 2013 was operated at
Hasan Sadikin General Hospital by a neurosurgeon
• Diagnose : Tumor at right lower jaw region suspect benign dd/
Osteoma
• Treatment : Plan to perform Right hemimandibulectomy/Operation on
Monday, July 11th 2022 at COT 311 (II)
• Ass Op. I  : Niken Laksmitarani, drg.
• Ass Op. II : Timotius A. Kadrianto, drg.
• Objective :
Date 08/07/22 09/07/22 10/07/22

BP
110/70 110/70 110/70
(x/minute)
P
78 80 79
(x/minute)
R
18 18 18
(x/minute)
T
36.5 36.6 36.5
(°C)
Laboratory
Finding
HEMATOLOGY 08/07/22
Antigen Test Negative
Laboratory Findings

HEMATOLOGY 08/06/22
Hb 13.9
Ht 42.5
WBC 8.65
RBC 4.80
Platelet 364,000
PT 13.1
APTT 28.40
INR 0.93
Timely Glucose 77
SGOT 24
SGPT 36
Ureum 9.6
Creatinine 0.62
Natrium 138
Kalium 4.4
Profile Photo
Intra Oral
 Chest X-Ray
(Hasan Sadikin General Hospital, June 8th 2022)
 Panoramic X-Ray
(Private Clinic at Sumedang area, April 26th 2022)
 3D Head CT Scan
(Hasan Sadikin General Hospital, May 31 st 2022)

Conclusion :
• Multiple lytic and sclerotic lesions giving a groundglass appearance on the frontal bone,
perpendicular plate of ethmoid bone, crista galli, superior orbital rima, bilateral greater wings of
sphenoid bone, left zygomaticum, bilateral ethmoid and sphenoid sinus walls, frontal process of
maxilla left, left concha nasalis, clivus, bilateral temporal bones, and right mandibular ramus. ?
suggestive of a craniofacial fibrous dysplasia
• Defects in the calvaria in the left frontoparietal area with soft tissue emphysema.
• Regular KGB enlargement as high as level IIA and IIB colli dextra and level IIB colli sinistra
• Slight deviation of the nasal septum to the right
 Head CT Scan
(Hasan Sadikin General Hospital, May 31 st 2022)

Conclusion :
• Multiple lytic and sclerotic lesions giving a groundglass appearance on the frontal bone,
perpendicular plate of ethmoid bone, crista galli, superior orbital rima, bilateral greater wings of
sphenoid bone, left zygomaticum, bilateral ethmoid and sphenoid sinus walls, frontal process of
maxilla left, left concha nasalis, clivus, bilateral temporal bones, and right mandibular ramus. ?
suggestive of a craniofacial fibrous dysplasia
• Defects in the calvaria in the left frontoparietal area with soft tissue emphysema.
• Regular KGB enlargement as high as level IIA and IIB colli dextra and level IIB colli sinistra
• Slight deviation of the nasal septum to the right
 Pathology Anatomy
(Hasan Sadikin General Hospital, May 10 th 2022)

Impression :
• Ostoema? a/r mandibula dextra
 3. Rohanah/F/57 y.o/0000069216/22120473/RIK IV (413W)
Date of Admission : 08/07/2022 Cell Phone No : 081343279588
Pre Op
Supervisor : Asri Arumsari, drg., Sp.BM(K)
A 57 years old female patient came with a embedded teeth. +/- 4 months prior to
admission, the patient complained of pain at the upper right wisdom tooth. +/- 2
months prior to admission the patient had her tooth examined at Hasan Sadikin
General Hospital, and was performed panoramic x-ray, then was advised to remove
her upper right wisdom tooth. The patient then went to a public health center at Dago
area, then was referred to a private hospital at Bandung area. +/- 1 month prior to
admission the patient was referred to Hasan Sadikin General Hospital further
treatment, was scheduled for surgery on Monday (14/07/22). History of systemic
disease (-), history of drug allergy (-) and food (+) cod fish, history of taking regular
medication (-) history of surgery (-). History to the dentist (+) scaling.
• Diagnose : Impacted of tooth 18
• Treatment : Plan to perform Odontectomy of tooth 18
/Operation on Monday, July 11th 2022 at COT
405 (I)
• Ass Op. I  : Cahyono Yudianto, drg.
• Ass Op. II : M. Adityo Nugroho, drg.
• Objective :
Date 08/07/22 09/07/22 10/07/22

BP
120/70 120/80 120/80
(x/minute)
P
82 80 81
(x/minute)
R
19 18 20
(x/minute)
T
36.6 36.6 36.5
(°C)
Laboratory
Finding
HEMATOLOGY 08/07/22
Antigen Test Negative
Laboratory Findings
HEMATOLOGY 01/07/22
Hb 13.8
Ht 43.4
WBC 6.61
RBC 4.99
Platelet 336,000
PT 12.8
APTT 31.80
INR 0.90
Timely Glucose 95
SGOT 18
SGPT 11
Ureum 19.3
Creatinine 0.70
Natrium 143
Kalium 5.1
 Chest X-Ray
(Hasan Sadikin General Hospital, July 1 st 2022)
 Panoramic X-Ray
(Hasan Sadikin General Hospital, May 18 th 2022)
4. Intan Permata Sari/F/24 y.o/0002051373/22120470/Fresia I (9.1)
Date of Admission : 08/07/2022 Cell Phone No : 087824616863
Pre Op
Supervisor : Asri Arumsari, drg., Sp.BM(K)

A 24 years old female patient came with embedded tooth. +/- 2 months prior to
admission, the patient complained of pain in the lower right wisdom tooth and swollen
gum. +/- 2 months prior to admission the patient went to public health center at Dago
area, and was immediately referred to private hospital at Bandung area but she didn’t
went to the hospital due to far distance, instead she was referred to an army hospital at
Bandung area. Then the patient was referred to Padjajaran University Dental Hospital for
panoramic x-ray and CBCT. +/- 1.5 months prior to admission, the patient went to an
army hospital at Bandung area, and her lower right wisdom tooth was extracted and an
embedded tooth at front upper jaw region was found, then she was referred to Hasan
Sadikin General Hospital for further treatment. +/- 1 month prior to admission, the
patient came to Hasan Sadikin General Hospital OMFS department with her panoramic
x-ray and was performed complete blood count, chest x-ray then was scheduled for
embedded tooth surgery on Monday (14/07/22). History of systemic disease (-), history
of drug and food allergies (-), history of taking regular medications (-) history of surgery
(-). History to the dentist (+) dental filling.
• Diagnose : Supernumerary tooth at 12-11 and 11-21 region
• Treatment : Plan to perform Odontectomy of supernumerary teeth at
12- 11 and 11-21 region/Operation on Monday, July 11th
2022 at COT 405 (II)
• Ass Op. I  : Cahyono Yudianto, drg.
• Ass Op. II : M. Adityo Nugroho, drg.
• Objective :

Date 08/07/22 09/07/22 10/07/22

BP
120/70 120/80 120/80
(x/minute)
P
80 78 80
(x/minute)
R
24 18 19
(x/minute)
T
36.5 36.6 36.5
(°C)
Laboratory
Finding
HEMATOLOGY 08/07/22
PCR SARS CoV2 Negative
Laboratory Findings
HEMATOLOGY 08/06/22
Hb 13.1
Ht 40.1
WBC 4.93
RBC 4.80
Platelet 252,000
PT 13.3
APTT 36.50
INR 0.94
Timely Glucose 83
SGOT 28
SGPT 26
Ureum 22.2
Creatinine 0.64
Natrium 139
Kalium 3.7
 Chest X-ray
(Hasan Sadikin General Hospital, June 29 th 2022)
 Panoramic X-Ray
(Padjajaran University Dental Hospital, December 27th 2022)
 CBCT
(Padjajaran University Dental Hospital, April 01st 2022)

Impression:
• Supernumerary ar. 11-21 , DDx Mesiodens with approximation of the nasopalatine canal
• Supernumerary ar. 11-12 with nasal cavity approximation
 CBCT
(Padjajaran University Dental Hospital, April 01st 2022)

Impression:
• Supernumerary ar. 11-21 , DDx Mesiodens with approximation of the nasopalatine canal
• Supernumerary ar. 11-12 with nasal cavity approximation
Post Op
5. Ziham Hafiz A./L/19 y.o/0002055078/22120467/RIK IV (405D)
Date of Admission : 07/07/2022 Cell Phone No : 082240250880
POD II
Supervisor : Asri Arumsari, drg., Sp.BM(K)
A 19 years old male patient came with a complaint of facial asymmetry of the
lower jaw being too advanced. +/- 4 years prior to admission, the patient
complains of a forward feeling in the lower jaw, frequent headaches, and pain in
the jaw joint. The patient went to an orthodontic specialist in the Buah Batu area
and was given fixed orthodontic treatment, and had regular check-ups every
month. +/- 4 months prior to admission the patient went control to an orthodontist
and was consulted to an oral surgeon and advised to have jaw surgery done at
Hasan Sadikin general hospital. +/- 3 weeks prior to admission the patient came to
Hasan Sadikin general hospital for consultation about treatment and preparation
for orthognathic surgery and was scheduled for orthognathic surgery. History of
systemic disease (-). History of drug and food allergies (-). History of taking
regular medication (+). Covid-19 vaccine history (+) 3 doses
• Diagnose : Post Osteotomy Lefort I with impaction + BSSO on
indication of Dysgnathy Clas III + Laterognathy
• Ass Op. I  : Niken Laksmitarani, drg.
• Ass Op. II : Ardian, drg.
• Objective :
Date 07/07/22 08/07/22 09/07/22 10/07/22
BP
(x/ 110/70 110/70 120/80 120/80
minute)
P
(x/ 80 78 81 80
minute)
R
(x/ 18 19 19 20
minute)
T
36.5 36.6 36.6 36.5
(°C)
Laboratory
Finding
HEMATOLOGY 07/07/22
Antigen Test Negative
Laboratory Findings
HEMATOLOGY 22/06/22 08/07/22
Hb 16.7 13.4
Ht 49.1 40.2
WBC 5.67 15.21
RBC 5.56 4.65
Platelet 223,000 170,000
PT 13.6
APTT 0.97
INR 32.80
Timely Glucose 83
SGOT 17
SGPT 16
Ureum 36.0
Creatinine 0.57
Natrium 145
Kalium 4.8
Profile Photo
Intra Oral
 Chest X-Ray
(Hasan Sadikin General Hospital, June 22 nd 2022)
 Panoramic X-Ray
(Pramita Laboratory, March 29th 2022)
 Chest X-Ray
(Pramita Laboratory, March 29th 2022)
 Schedel X-Ray
(Hasan Sadikin General Hospital, July 07 th 2022)
Intra Op
POD I
POD II
 6. Jaja Wahyu/M/38 y.o/2048242/22120452/Fresia III (2.2)
Date of Admission : 06/07/2022 Cell Phone No : 083878528819
POD III
Supervisor : Winarno Priyanto, drg., Sp.BM(K)
A 38 years-old patient came with lump at his right lower jaw and cheek region. +/- 6 years
prior to admission the patient complained of a lump on the right lower jaw the size of a corn
kernel, painless and didn’t easily to bleed with an irregular shape but the patient didn’t seek
any treatment. +/- 1 year prior to admission the patient felt the lump getting bigger as big as
of a table tennis ball, bleeds occasionally, painful when chewing hard food. Then the patient
went to the public health center at Subang area, was given analgesic (the patient forgot the
name of the medicine), then he was referred to Hasan Sadikin General Hospital but he didn’t
go there. +/- 1 month prior to admission admission the patient felt the lump getting bigger as
big as of a chicken egg and bleeding. then he went to a public hospital at Subang area then
was referred to Hasan Sadikin General Hospital for further treatment and was performed
incisional biopsy under local anesthesia on 27/05/22 with result of Ameloblast plexiform
type at right lower jaw region. +/- 2 weeks prior to admission he went to Hasan Sadikin
General Hospital OMFS clinic and was performed complete blood count, chest x-ray and
was scheduled for surgery at Thursday (07/07/22). History of weight loss (+) 2 kgs in 3
months, history of systemic disease (+) hypertension, routine drug consumption (-),
food/drug allergy (-), Covid-19 vaccine history (+) 2 doses.
• Diagnose : Post Right hemimandibulectomy + Plate AO reconstruction +
Extraction of tooth 45 on indication of Ameloblastoma
plexiform type at right mandible region
• Ass Op. I  : Bambang Hudiworo, drg.
• Ass Op. II : Ardian, drg.
• Objective :
Date 06/07/22 07/07/22 08/07/22 09/07/22 10/07/22

BP
(mmHg) 110/70 110/70 120/70 120/80 120/80

P
(x/minute) 84 85 81 82 80

R
(x/minute) 19 20 20 19 20
T
(°C) 36.7 36.6 36.6 36.7 36.6
Laboratory
Finding
HEMATOLOGY 06/07/22
Antigen SARS CoV2 Negative
Laboratory Findings
HEMATOLOGY 13/06/22 07/07/22 09/07/22 10/07/22
Hb 16.2 13.3 11.7 11.8
Ht 51.0 41.7 37.8 37.0
WBC 20.63 27.85 21.59 15.82
RBC 5.95 4.85 4.31 4.35
Platelet 398,000 320.000 292,000 293,000
PT 13.7 15.0
APTT 29.10 28.10
INR 0.97 1.06
Timely Glucose 74
SGOT 16
SGPT 14
Ureum 23.2
Cretinine 0.89
Natrium 136
Kalium 3.2
Profile Photo
Intra Oral
 Chest X-Ray
(Hasan Sadikin General Hospital, June 13 th 2022)
 Panoramic X-Ray
(Hasan Sadikin General Hospital, June 08 th 2022)
 Pathology Anatomy
(Hasan Sadikin General Hospital, May 07 th 2022)

Impression :
• Ameloblastoma pelexiform type at right mandible
Intra Op
POD I
POD II
POD III
7. Anton Darmawan/M/38 y.o/2058713/2200014999/Kemuning IV (10.4)
Date of Admission : 05/07/2022 Cell Phone No : 087714493956
POD III
Supervisor : Eka Marwansyah, Oli’i, drg., Sp.BM(K)

A 38 years old male patient came with swelling at right lower jaw extended to chin and left
lower jaw region. ± 5 days prior to admission, the patient complained of toothache at right
lower teeth, then the swelling occured at right lower jaw region, but he didn’t seek any
treatment. ± 2 days prior to admission the patient complained of toothache then he went to a
dentist at Cilekong area and was performed extraction of his right lower tooth and was given
5 kind of medicines (the patient forgot the name of the medicines). ± 18 hours prior to
admission, the swelling got bigger then he went to Kebon Jati private hospital and was
performed chest x-ray, then he was referred to Hasan Sadikin Hospital Emergency ENT
Department for further treatment. Altered voice (+), Hot potato voice (-), hoarseness (+),
pain on swallowing (+), neck stiffness (-) History of systemic disease (-). History of taking
routine drug consumption (-).
Diagnose : Post Incision drainage through and through at right
submandible, submental, left submandible region + Extraction of
teeth 15,16 on indication of Right submandible abscess extended to
submental and left submandible due to chronic apical periodontitis
due to gangrene pulp of tooth 47 + Chronic apical
periodontitis due to radices of tooth 16 and gangrene pulp of tooth 15
• Supervisor : Eka Marwansyah Oli’i, drg.,Sp.BM(K)
• 1st Chief on Duty : Stephanus Christianto, drg
• 2nd Chief on Duty : Yasinnurrasyad Azmabasyar R, drg, Muhammad Adityo
Imam N, drg
• Objective :

Date 05/07/22 06/07/22 07/07/22 08/07/22 09/07/22 10/07/22

BP
120/70 120/80 110/78 120/80 110/80 120/80
(mmHg)

P
85 82 84 84 82 80
(x/minute)

R
21 19 20 20 19 20
(x/minute)

T
36.5 36.6 36.7 36.7 36.6 36.5
(°C)
Laboratory
Finding
HEMATOLOGY 05/07/22
Antigen SARS CoV2 Negative
 Laboratory Findings
07/07/22 07/07/22 08/07/22 08/07/22 08/07/22
HEMATOLOGY 05/07/22 06/07/22 06/07/22 09/07/22 10/07/22
15.00 20.00 10:00 15:00 20:00
Hb 14.0 13.4
Ht 39.6 37.9
WBC 25.74 9.71
RBC 4.86 4.71
Platelet 388,000 431,000
PT 15.1
APTT 27.80
INR 1.07
Timely Glucose 501 269 309 252 349 343 357 250
Fasting Glucose 232
SGOT 15
SGPT 15
Ureum 25.7
Cretinine 1.04
Natrium 127
Kalium 3.8
HbA1c 9.2
Profile Photo
Intra Oral
 Chest X – Ray
(Hasan Sadikin General Hospital, July 5th 2022)
 Neck Soft Tissue AP-Lat X-Ray
(Hasan Sadikin General Hospital, July 5th 2022)
 Panoramic X-Ray
(Hasan Sadikin General Hospital, July 6th 2022)
Tapping Pus
Durante Op
Post Treatment
POD I
POD II
POD III
FOLLOW UP
 1. Robiah/F/28 y.o/2012703/2200014246/Fresia II (8.5)
Date of Admission : 25/06/2022 Cell Phone No : 0816854807
Supervisor: Winarno Priyanto, drg., Sp.BM(K)

A 28 years old female patient came with swelling at left cheek region. ± 6 months prior to admission, the
patient complained of toothache at her upper left teeth, then appears a lump as a size of a corn kennel
with a hard consistency, not easy to bleed, not pain. ± 2 weeks prior to admission she took a medicine at
Private Clinic at Pemalang area, then she took an analgetic medicine (she forgot the name of the
medicine) but she didn’t get better and suggested to go to Oral and Maxillofacial Surgeon. ± 5.5 months
prior to admission, the swelling got bigger as a size of chicken egg, then she went to OMFS outpatient
clinic at Karawang area and was performed complete blood count, chest x-ray, usg mass x-ray, and
incisional biopsy in general anesthesia, with the diagnose fibrohistiocytoma dd/ fibromyxoid. Then the
patient was referred to Hasan Sadikin Hospital Emergency Department for further treatment. Then the
swelling got bigger and she was scheduled for hemimaxillectomy, tracheostomy and close defect join op
with Oncology and Plastic Surgery with the pathological anatomy result is Rhabdomyosarcoma. ± 2
months prior to admission the swelling was arise at the buccal and palate region with the size like a ping
pong and got bigger with the size like melon. Then the patient was went to Hasan Sadikin Hospital
OMFS outpatient clinic and be scheduled to Join Conference with Hasan Sadikin Hospital Cancer Team.
The JC result was the patient must be get a radiotherapy treatment and she already got 3 cycles of
radiotherapy. History of taking regular medication (+) amoxicillin and paracetamol, history of weight
loss (+) in 3 months, history of medicine and food allergies (-), history of radiotherapy (+) 3 cycles
 • Diagnose : Post Left hemimaxillectomy + Wide excision +
Diagnostic frozen section + closed defect with local flap
+ Rhabdomyosarcoma at left buccal region post 3rd
radiotherapy, paraneoplastic syndrome + Leukocytosis +
Thrombocytosis + Hyponatremia + Anemia deficiency Fe
due to tumor bleeding
• Therapy : Plan to perform general condition improvement
• Objective :

Date 25/06/22 26/06/22 27/06/22 28/06/22 29/06/22 30/06/22 01/07/22 02/07/22 03/07/22 04/07/22 05/07/22 06/07/22 07/07/22 08/07/22 09/07/22 10/07/22

BP
(mmHg) 120/80 120/80 120/70 120/70 120/80 120/70 110/70 110/80 120/70 120/70 110/70 110/80 110/76 120/80 110/80 120/80

P
(x/minute) 81 80 78 80 78 80 82 82 84 82 86 82 81 80 82 80

R
(x/minute) 19 20 20 22 20 20 20 22 20 20 21 22 21 20 22 21

T
(°C) 36.6 36.5 36.5 36.4 36.4 36.5 36.6 36.4 36.5 26.5 36.6 36.4 36.6 36.6 36.4 36.5
Laboratory Finding
HEMATOLOGY 25/06/22
Antigen SARS CoV2 Negative
Laboratory
Findings
28/06/22 28/06/22
HEMATOLOGY 25/06/22 26/06/22 27/06/22 30/07/22 01/07/22 02/07/22 04/07/22 05/07/22 07/07/22
(14.35) (23.11)
Hb 3.1 5.2 6.1 6.7 7.5 7.5 7.1 7.7 10.7 9.7
Ht 10.4 18.8 18.0 20.3 22.3 22.6 20.9 22.4 32.2 29.5
WBC 20.48 13.16 11.18 5.77 5.24 18.59 10.29 11.45 9.76 9.03
RBC 1.66 2.16 2.32 2.60 2.89 3.03 2.73 2.88 3.93 3.54
Platelet 684,000 371,000 253,000 138,000 78,000 65,000 50,000 68,000 150,000 256,000
PT 10.40 12.30 12.8 14.6
APTT 22.80 33.60 26.8 27.90
INR 0.91 1.06 0.89 1.03
Timely Glucose 103 212 94 117 137
SGOT 33 68 25 48
SGPT 21 25 32 25 41
Albumin 1.90 2.30 2.70
Ureum 20.4 7.8 11.8 17.1 17.1 6.4
Creatinine 0.45 0.43 0.49 0.35 0.27 0.27
Natrium 112 123 131 132 134
Kalium 4.4 2.7 3.7 3.5 4.0
 Chest X-Ray
(Hasan Sadikin General Hospital, June, 25th 2022)
 Panoramic X-Ray
(Private Hospital at Karawang area, December 14th 2022)
 USG Mass
(Hasan Sadikin General Hospital, December 14th 2021)

Impression:
• Appears to be solid mass measuring 4.2x3.3x4.3 cm in left buccal area of DD/abscess
• No enlargement of the lymph nodes in the right-left colli area is seen
 USG Abdomen
(Hasan Sadikin General Hospital, June 29th 2021)

Impression:
• Hepatosplenomegaly with inhomogenity of liver parenchyme
• Cholecystitis
• Ascites
• No enlargement of the lymph nodes in paraaorta/parailiaca
• USG of pancreas, both kidney, vesica urinary tract didn’t show any anomalies
 Head CT Scan
(Hasan Sadikin General Hospital, January 29th 2022)

Impression:
• Solid mass in left buccal, medially infiltrating left mandibular gland, left parotid gland, m. left
masseter, left temporal, left digastic, medial pterygoid and left lateral pterygoid encase v. left
jugular, urgent a. the left internal and external carotid. Superiorly infiltrates the left maxillary sinus,
left nasal cavity. Destruction of the left medial and lateral pterygoid plate, left maxillary sinus and
left concha. Solid lesion in right thyroid lobe
 3D Head CT Scan
(Hasan Sadikin General Hospital, January 29th 2022)

Impression:
• Solid mass in left buccal, medially infiltrating left mandibular gland, left parotid gland, m. left
masseter, left temporal, left digastic, medial pterygoid and left lateral pterygoid encase v. left
jugular, urgent a. the left internal and external carotid. Superiorly infiltrates the left maxillary sinus,
left nasal cavity. Destruction of the left medial and lateral pterygoid plate, left maxillary sinus and
left concha. Solid lesion in right thyroid lobe
 Head CT Scan
(Hasan Sadikin General Hospital, May 31st 2022)

Impression:
• Solid mass at left buccal region extended to superior infiltrated m. temporalis sinistra, m. orbicularis oculi sinistra, m. masseter sinistra, m.
medial dan lateral pterygoid sinistra, m. superior constrictor sinistra, m. longus capitis sinsitra, m. rectus capitis sinistra, septum nasi,
nasomeatal sinistra, submandibular sinistra, kelenjar parotis sinistra dan sebagian ruang retrobulbar sinistra. Obliterated fossa rosenmuller
sinistra, torus tubarius sinistra, palatum durum, palatum mole, lingual tonsil, root of tongue, valekula epiglottis, intrinsik and ekstrinsik
muscle of bilateral tongue, m. digastricus sinistra, sinus ethmoidalis sinistra, sinus maksilaris sinistra, sinus sphenoidalis sinistra, sinus
cavernosus sinistra, ductus lakrimalis sinistra, m. rectus inferior sinistra, concha nasalis sinistra, pharyngeal tonsil, dan tuba eustachii
sinistra. Narrowing sublingual space bilateral, buccal space sinistra, mucosal pharyngeal space sinistra, masticator space sinistra,
submandibular space sinistra, parotid space sinistra, carotid space sinistra, retropharyngeal space sinistra, parapharyngeal space sinistra dan
fossa infratemporalis sinistra. Destructed lateral, medial, dan posterior wall of sinus maxillary sinistra, ethmoidal cells sinisitra, greater
wing os sphenoid sinsitra, os temporal sinistra, pterygoid plate medial and lateral sinistra, os zygomaticum sinistra, apex of os petrosa
sinistra dan medial wall of orbital cavity sinistra.
• Pressing a. karotis komunis sinistra, carotis interna sinistra artery, karotis externa sinistra artery and v. jugularis sinistra. into inferior
destruction a head , angle, ramus dan dentoalveolar mandibula sinistra. Erosion hyoid one and kartilago thyroid appearance. Infiltrated
plica aryepiglottica sinistra, epiglottis and vallecula epiglottis. The lesion narrowing the air collom at orpus vertebrae level C1-C6.
Comparison old CT Scan lesion get bigger, there was no enlargement lymphe node at bilateral neck. There was no intracranial metastasis,
T4bN0M0
• Solid lesion without calsification at right thyroid lobus
• Left Otomastoiditis
 3D Head CT Scan
(Hasan Sadikin General Hospital, May 31st 2022)

Impression:
• Solid mass at left buccal region extended to superior infiltrated m. temporalis sinistra, m. orbicularis oculi sinistra, m. masseter sinistra, m.
medial dan lateral pterygoid sinistra, m. superior constrictor sinistra, m. longus capitis sinsitra, m. rectus capitis sinistra, septum nasi,
nasomeatal sinistra, submandibular sinistra, kelenjar parotis sinistra dan sebagian ruang retrobulbar sinistra. Obliterated fossa rosenmuller
sinistra, torus tubarius sinistra, palatum durum, palatum mole, lingual tonsil, root of tongue, valekula epiglottis, intrinsik and ekstrinsik
muscle of bilateral tongue, m. digastricus sinistra, sinus ethmoidalis sinistra, sinus maksilaris sinistra, sinus sphenoidalis sinistra, sinus
cavernosus sinistra, ductus lakrimalis sinistra, m. rectus inferior sinistra, concha nasalis sinistra, pharyngeal tonsil, dan tuba eustachii
sinistra. Narrowing sublingual space bilateral, buccal space sinistra, mucosal pharyngeal space sinistra, masticator space sinistra,
submandibular space sinistra, parotid space sinistra, carotid space sinistra, retropharyngeal space sinistra, parapharyngeal space sinistra dan
fossa infratemporalis sinistra. Destructed lateral, medial, dan posterior wall of sinus maxillary sinistra, ethmoidal cells sinisitra, greater
wing os sphenoid sinsitra, os temporal sinistra, pterygoid plate medial and lateral sinistra, os zygomaticum sinistra, apex of os petrosa
sinistra dan medial wall of orbital cavity sinistra.
• Pressing a. karotis komunis sinistra, carotis interna sinistra artery, karotis externa sinistra artery and v. jugularis sinistra. into inferior
destruction a head , angle, ramus dan dentoalveolar mandibula sinistra. Erosion hyoid one and kartilago thyroid appearance. Infiltrated
plica aryepiglottica sinistra, epiglottis and vallecula epiglottis. The lesion narrowing the air collom at orpus vertebrae level C1-C6.
Comparison old CT Scan lesion get bigger, there was no enlargement lymphe node at bilateral neck. There was no intracranial metastasis,
T4bN0M0
• Solid lesion without calsification at right thyroid lobus
• Left Otomastoiditis
 Pathology Anatomy
(Private Hospital at Karawang area, December 23rd 2021)

Impression:
• Benign Fibrohistiocytoma dd/ Fibromyxoid
 Pathology Anatomy
(Hasan Sadikin General Hospital, February 22nd 2022)

Impression:
• Rhabdomyosarcoma
EMERGENCY
 1. Ricki Rustandi/M/22 y.o/2058713/2200014999/IGD Bedah
Date of Admission : 07/07/2022 Cell Phone No : 087714493956
EMERGENCY
Supervisor : Seto Adiantoro, drg., Sp.BM(K)

A 22-year-old male patient came with bleeding from the mouth. +/- 2 hours prior to
admission when the patient was driving a motorcycle with medium speed in Cijerah area, the
patient was overtaking the car in front of him, suddenly a car from the opposite direction hit
him then caused the patient lost his balance and fell with the mechanism of his face hit the
asphalt first. History of using a helmet (-). History of unconsciousness (+) +/- 15 minutes,
nausea and vomiting (-) history of bleeding from mouth (+), bleeding from nose (+) and
bleeding from ears (+). History of alcohol intoxication (-). The patient was brough to the
Hasan Sadikin Emergency Department for further treatment.
• Diagnose : Dentoalveolar fracture at teeth 12-21 region + Lacerated
wound at right eyelid, right cheek, lower lip, and chin region +
Punctured wound at upper lip region
• Therapy : Plan to perform Suturing lacerated wound IO EO +
Interdental wiring
• 1st Chief on Duty : Bambang Hudiworo, drg
• 2nd Chief on Duty : Rony Afrizal, drg., George Abraham, drg.
• Objective

Date 07/07/22
BP
120/70
(mmHg)

P
83
(x/minute)

R
21
(x/minute)

T
36.5
(°C)
Laboratory
Finding
HEMATOLOGY 07/07/22
Antigen SARS CoV2 Negative
Laboratory Findings

HEMATOLOGY 07/07/22
Hb 15.4
Ht 46.1
WBC 20.51
RBC 5.21
Platelet 285,000
Profile Photo
Extra Oral
Intra Oral
 Chest X – Ray
(Hasan Sadikin General Hospital, July 7th 2022)
 Skull AP Lateral X – Ray
(Hasan Sadikin General Hospital, July 7th 2022)
 3D Head CT Scan
(Hasan Sadikin General Hospital, July 7th 2022)
Post Debridement
Post Treatment
SUPERVISOR ATTENDANCE LIST
THANK YOU