<p class="Abstract"><strong><em> ABSTRACT</em></strong></p><p class="TextAbstract"><strong><em>Introduction:</em></strong><em> Diaphragmatic rupture is a major challenge for the radiologist to be confirmed as an emergency diagnosis. The prevalence of the injury is 5% of abdominal blunt force trauma cases. Left-sided injury is more common with left-to-right ratio 3:1. Chest X-Ray is a conventional modality as an early assessment of abdominal trauma and computed tomography is a standard reference to confirm this diagnosis.</em></p><p class="TextAbstract"><strong><em>Case Report:</em></strong><em> A 70 yo man complained about chest pain after falling from 4 meter-height tree. Chest X-Ray revealed bowel gas appearance in the left thorax cavity with no appearance of left diaphragm. Contrasted abdominal CT showed gaster and intestine in the left thorax cavity. The patient underwent left diaphragm thoracotomy confirming the existence of gaster, ileum, and spleen in the pleural cavity. Those organs were returned to the abdomen and the left diaphragm repaired. Following-up after discharge obtained remarkable outcomes.</em></p><p class="TextAbstract"><strong><em>Discussion:</em></strong><em> Confirming the diagnosis of diaphragmatic rupture is a challenge for the radiologist because it can be asymptomatic until life-threatening complications manifest such as respiratory disorders and visceral incarceration.</em></p><p class="TextAbstract"><strong><em>Conclusion</em></strong><em>: With the improvement of imaging technology, the radiologist is able to confirm a diaphragmatic rupture to get a better prognosis. </em></p><p class="TextAbstract"><em> </em></p><p class="TextAbstract"><strong><em>Key words: </em></strong><strong><em>diaphragmatic rupture</em></strong><strong><em>; trauma</em></strong><strong><em>; </em></strong><strong><em>chest X-</em></strong><strong><em>ray</em></strong><strong><em>; computed tomography</em></strong></p><p class="TextAbstract"><strong> </strong></p><p class="TextAbstract" align="center"><strong>ABSTRAK</strong></p><p class="TextAbstract" align="center"><strong> </strong></p><p class="TextAbstract"><strong>Pendahuluan</strong> : Konfirmasi diagnosis emergensi ruptur diafragma masih menjadi tantangan bagi spesialis radiologi. Prevalensi ruptur diafragma sebesar 5% dari kasus trauma tumpul abdomen dan perlukaan diafragma pada sisi kiri lebih umum terjadi dibandingkan sisi kanan dengan rasio 3:1. Foto X-Ray dada merupakan modalitas konvensional sebagai penilaian awal trauma abdomen dan <em>computed tomography scanning</em> (CT scan) merupakan standar pemeriksaan untuk mendiagnosis kasus tersebut.</p><p class="TextAbstract"><strong>Laporan Kasus </strong>: Seorang laki-laki berusia 70 tahun mengeluhkan nyeri dada setelah jatuh dari pohon setinggi 4 meter. X-ray dada menunjukkan gambaran gas usus di sebelah kiri rongga thorax dan tidak tampak gambaran diafragma kiri. CT scan abdomen dengan kontras menunjukkan gambaran lambung dan usus di sebelah kiri rongga thorax. Pasien tersebut kemudian ditatalaksana dengan thorakotomi diafragma kiri untuk mengkonfirmasi adanya lambung, ileum dan lien pada rongga pleura. Organ-organ tersebut kemudian dikembalikan ke dalam abdomen dan diafragma kiri direparasi. Kondisi klinis pasien setelah penatalaksanaan tersebut menunjukkan perbaikan.</p><p class="TextAbstract"><strong>Diskusi</strong> : Konfirmasi diagnosis ruptur diafragma merupakan tantangan bagi spesialis radiologi karena kasus tersebut bisa tidak bergejala sampai timbulnya komplikasi yang mengancam jiwa seperti gangguan respirasi dan perlekatan organ visceral.</p><p class="TextAbstract"><strong>Kesimpulan : </strong>Dengan adanya perkembangan teknologi<strong> </strong>pencitraan, spesialis radiologi dapat mengkonfirmasi ruptur diafragma sehingga memberikan prognosis yang lebih baik.</p><p class="TextAbstract"> </p><p class="TextAbstract"><strong>Kata Kunci : ruptur diafragma</strong><strong><em>; </em></strong><strong>trauma;<em> </em></strong><strong><em>chest X-ray, computed tomography</em></strong></p>

This research aimed to find out the factors affecting the farmers in adopting refugia system as an attempt of conserving biodiversity of farm ecosystem. The location of research was selected purposively, Wonogiri Regency. The informants were selected using purposive sampling technique, consisting of rice farmers who have acquired information about refugia system, Agricultural Extension Officer (PPL), and Plant Disease Controller – Pest and Disease Observer (POPT-PHP). The fundamental research method employed was qualitative one with case study approach. Data analysis was conducted using an interactive model of data analysis. Data validation was carried out using source and method triangulations. The result of research showed that the factors affecting the farmers in adopting refugia system are characteristics of individual farmers, refugia system with varying benefits, farmer group as social system, interpersonal communication channel, farmers and groups’ types of decision, and condition of agricultural extension officer and pest observer.

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