Background: There are various surgical methods for hemorrhoid. Currently, there is no data regarding the profile and clinical outcome of surgery on internal hemorrhoids, especially between open hemorrhoidectomy and stapled hemorhoidopexy at Dr. Soetomo General Hospital. We aimed to describe the profile and outcome of internal hemorrhoidal patients. Methods: We collected samples from all patients with internal hemorrhoid who visited the emergency department and outpatient from January 2018 – to April 2022. The data are secondary data taken from medical records. We collected patients’ demographic data (e.g., age and sex), disease severity, comorbidities, therapies, length of stay, and complications. Results: We recruited a total of 615 patients, consisted of 47 cases (7.6%) undergoing hospitalization and 568 (92.4%) outpatient treatment. Male patients dominate the distribution by sex, either in inpatient or outpatient settings. The mean age of patients is 46.6 years for outpatients and 44.6 years for inpatients. The majority of internal hemorrhoid grading is grade 2 for outpatient and grade 3 for inpatient. Most of the patients who came with comorbidities had metabolic disorders (48.1%). The stapled hemorrhoidopexy procedure has a fairly low level of pain than open hemorrhoidectomy. In this study, it was found that the average length of stay of patients after stapled hemorhoidopexy was shorter than open hemorrhoidectomy. Conclusion: Internal hemorrhoid patients who underwent the most surgeries at Dr. Soetomo General Hospital Surabaya is a male aged > 50 years with grade 3. Stapled hemorrhoidopexy has fewer pain complications than open hemorrhoidectomy and shorter length of stay.

Background: Acute appendicitis is the most common cause of abdominal surgery. The delay of diagnosis and surgery increases the risk of perforated appendicitis, which is associated with increased morbidity and mortality. The COVID-19 pandemic has an impact on the delays in the diagnosis (time-to-diagnosis) and therapy (time-to-intervention). In this study, we aimed to analyze the profiles and characteristics of acute appendicitis patients in COVID-19 pandemic and non-pandemic periods in Indonesia. Methods: We collected samples from all patients with acute appendicitis who visited the emergency department from November 10, 2018 – February 10, 2020 (non-COVID-19 pandemic) and March 11, 2020 – August 11, 2021 (COVID-19 pandemic). The data are secondary data taken from medical records. We collected the patient’s demographic data (e.g., age and sex), operation description, length of stay, and duration of the operation. Results: We recruited a total of 121 patients, consisting of 56 patients during the non-pandemic period and 65 patients during the pandemic. Based on the severity, patients with grade 1 were the most common during the non-pandemic period, while patients with grade 4 were the most common during the pandemic. There was a significant difference between the severity of acute appendicitis during the non-pandemic and the pandemic (P < 0.0001). During non-pandemic periods, the majority of patients were hospitalized for 3-4 days, while during the pandemic, the majority of patients required hospitalization of up to 5-6 days. Conclusion: There was a substantial difference in the severity of acute appendicitis patients during the COVID-19 pandemic and non-pandemic periods.

The treatment of peptic ulcers has changed substantially, and the rate of elective surgery for gastroduodenal peptic ulcers has fallen significantly; as a result, the rate of emergency surgery for perforated peptic ulcers has slightly increased. The Boey score is one of the most widely used prognostic scoring systems for predicting death in peptic ulcer perforation patients. The Boey scoring system has a positive connection with mortality risk. Patients with Boey Score 3 are patients who meet the high-risk criteria and have high morbidity and mortality rates. Conservative therapy can be utilized as an alternative to surgery in some cases with perforated gastroduodenal ulcers. In this study, we presented a clinical case of perforated peptic ulcer patient with Boey score 3 treated with external drainage for the conservative treatment.

Background: A widespread intra-abdominal organ infection or complicated intra-abdominal infection (cIAI) causes localized peritonitis, intra-abdominal abscess, and diffuse peritonitis. Patients suffer from morbidity and mortality as a result of this condition. Sepsis indicators such as SOFA, WSESSSS, and CPIRO scores were predictors of mortality in cIAI patients. We aimed to examine the performance of WSESSSS, CPIRO, and SOFA scoring systems to predict mortality in patients with cIAI. Methods: A retrospective cohort, analytic observational study was conducted to assess differences in SOFA, WSESSSS, and CPIRO scoring systems' sensitivity, specificity, and accuracy as predictors of death during treatment in cIAI patients in Dr. Soetomo General Hospital, Surabaya. Results: A total of 265 patients were evaluated. The optimal cutoff for SOFA was score 5 with sensitivity, specificity, PPV, NPV, and accuracy of 77.2%, 87.9%, 77.2%, 87.9%, and 84.2%, respectively. The optimal cutoff for WSESSSS was score 8 with sensitivity, specificity, PPV, NPV, and accuracy of 83.7%, 82.7%, 72.0%, 90.5%, and 83.0%, respectively.  The optimal cutoff for CPIRO was 4 with sensitivity, specificity, PPV, NPV, and accuracy values of 62.0%, 90.2%, 77.0%, 81.7%, and 80.4%, respectively. Patients with high scores had a higher percentage of being hospitalized longer and cost higher than patients with a low score. Conclusion: The SOFA, WSESSSS, and CPIRO scoring systems had comparable performance in predicting mortality in patients with cIAI. Considering the performance of WSESSSS, the use of WSESSSS alone may be sufficient enough to predict the outcome of patients with cIAI in Indonesia.