A young adult woman was escorted by the investigator to a forensic installation for examination. Based on patient information, she was forced to have sex with her husband about a few hours ago. This incident has occurred several times during the two years of their marriage age. According to the patient, their marriage relationship is less harmonious and there is often mouth argument. In addition, the patient admitted to being often beaten by her husband in a state of anger. The first patient to report to the police because they can not stand it.

1. PANEL
“DOMESTIC VIOLENCE (KDRT)”
MEDICAL FACULTY
MUSLIM UNIVERSITY OF INDONESIA
2018
GROUP 15BY:
TUTOR : dr. Zulfamidah

2. GROUP
15
Innal Hamda 11020150019
Andi Aisyah Zealand 11020150051
Afrina Febriana Bustan 11020150076
Rifqi Aditya 11020150078
Donita Rian Utami 11020150080
A. St. Zuraidha P. A. 11020150081
Rindang Cahyani P.H. Abas 11020150101
Feby Wahyuni Syam 11020150104
Fathania Rizky Diennillah 11020150131
Muhammad Fauzan 11020150151

3. a r i o
2.1
 A young adult woman was escorted by the investigator to a forensic installation for
examination. Based on patient information, she was forced to have sex with her
husband about a few hours ago. This incident has occurred several times during the
two years of their marriage age. According to the patient, their marriage
relationship is less harmonious and there is often mouth argument. In addition, the
patient admitted to being often beaten by her husband in a state of anger. The first
patient to report to the police because they can not stand it.

4. KEY WORDS
A young adult
woman
She was forced
to have sex with
her husband
about a few
hours ago
This incident has
occurred several
times
Their marriage
relationship is
less harmonious
The patient
admitted to
being often
beaten by her
husband in a
state of anger

5. What are the
characteristics of the
wound from the scenario?
1

6.  Description :
 Side : irregular
 Border : clear
 Surface: flat
 Colour : dark blue to
purple
Localization :
There was a
bruise on the left
inner thigh
Axis and ordinat
can’t determined
because center’s
line body can’t be
seen
The size of
wound can’t
be measured
Region : Left thigh
Kind of wound :
closed wound
Shaped of wound :
oval shaped

7.  Description :
 Side : irregular
 Border : clear
 Surface: flat
 Colour : blue
Localization : A
bruise on the left
arm of the outer
side
Axis and ordinat
can’t determined
because center’s
line body can’t be
seen
The size of
wound can’t
be measured
Region : Left arm
Kind of wound :
closed wound
Shaped of wound :
oval shaped

8.  Description :
 Side : irregular
 Border : clear
 Surface: flat
 Colour :
greenish-yellow
Localization : A
bruise on the
upper right arm
of the front side
Axis and ordinat
can’t determined
because center’s
line body can’t be
seen The size of
wound can’t
be measured
Region : Right arm
Kind of wound :
closed wound
Shaped of wound :
oval shaped

9.  Localization : A blister on vaginal wall
at six-hour o’clock
 Region : Genitalia
 The size of wound can’t be measured
 Shaped of wound : irregular oval
shaped
 Kind of wound : closed wound
 Description :
 Side : irregular
 Border : clear
 Surface: flat
 Colour : redness

10. What is the conclusion of
the diagnosis (wound
categorization) from the
scenario?
2

11. Diagnosis
 On examination found abrasion on vagina wall at six clockwise that caused by
blunt object that passed through vagina wall. Also found three other violence
marks on the other site of the body. One on inner side of left thigh, one on
outer side of upper arm, and one on front side of right upper arm. Wound on
inner side of left thigh is bruise that caused by blunt object, bruises colored
dark blue to purple that estimated 1-18 hours. Wound on outer side of upper
arm is bruise that caused by blunt object, bruises colored blue that estimated
1-2 days. And on front side of right upper arm is bruise that caused by blunt
object, bruises colored yellow that estimated 3-7 days.

12. How is the wound / trauma
patomechanism (using
knowledge of the anatomy,
histology, and physiology of the
human body) from the scenario?
3

13. ANATOMY OF THE SKIN

14. HISTOLOGY OF THE SKIN

15. A bruise (echymosis) is a
collection of blood beneath the
skin, resulting from
extravasations of blood from
surrounding vessels, without
breaking the epidermis layer of
skin.

17. ANATOMY OF FEMALE GENITALIA
Laseration at 6
o’clock

18. HISTOLOGY OF VAGINA

19. PHYSIOLOGY OF FEMALE SEXUAL RESPONSE
Stage of rest (not aroused)
The excitement stage involves sensory stimuli
Plateu phaseu
The orgasm stage; involves ejaculation, muscle contraction
Stage resolution (includes post-intercourse)

20. PATHOMECHANISM OF INJURY
In scenarios that occur in
the victim is a bruise on the
limbs and also abrasions in
the victim's vagina.
Bruises on the victim's body
caused by the presence of
blunt object with the
patient's body causing the
rupture of blood vessels
without damaging the skin
layer.
Due to the rupture of the
blood vessels cause a color
on the skin that can be seen
by the eye and will change
color as time passes.
 In the first and second images of the bruise color is purplish red and blue which means age
bruises are under the age of 4 days. While in the third picture of yellow bruises that
indicate the age of bruising 7-10 days.
BRUISE

21. PATHOMECHANISM OF INJURY
The blisters that occur
in the vagina of the
patient is caused by
sexual intercourse by
the husband.
forced to have sexual
intercourse?
the victim does not
experience a phase of
stimulation
the bartholini gland
will not release mucus
doesn’t serve vaginal
lubrication.
This means that when
the victim associated
with the husband, the
victim's vagina in a
state of
The damaged vaginal
lining reaches lamina
propia which can be seen
from the blood dries up in
the victim's vagina.
BLISTER

22. What is the cause of
possible injury
(CODamage) using the
proximus morbus (PMA)?
4

23. Current finding
A-1
A-2
A-3
B
Three bruise on the left side of the thigh, arm
outside the left side and the front upper right arm
Extravasation of blood into the interstitial tissue
Ruptured blood vessels
Blunt force trauma
-

24. Current finding
A-1
A-2
B
Anal sphincter muscle tone disappeared
Damaged of outer skin and extravasation of blood
under the skin
Blunt force trauma
-

25. What is the possible
characteristics of the
injury-causing agent?
5

26. CAUSATIVE AGENTS
 Contusion
Contusion is caused usually due to an injury
produced by a blunt object like bamboo stick,
iron rod, stone, or a blow by fist or boot or by a
fall or by compression of crushing etc, besides
being due to some disease.
-Nelwan, Berti. Bahan Kuliah Blunt Force Trauma. 2018. Fakultas Kedokteran UMI.
-Prof. J.P. Saxena (Medicolegal expert cum Toxicologist and Advocate). Medicolegal significance of Bruise. http://www.legalserviceindia.com/medicolegal/bruise.htm
The shape of the bruise is most likely to reflect
the shape of the causative object when the object
is small and hard and death occurs soon after
injury,
A doughnut bruise is produced by an object with a
rounded contour (e.g. baseball). Two parallel
linear bruises result from a blow with a rod or
stick
Bruises can follow rounded
contours if they are caused
by a flexible object like a
lash.
The possible cause of contusion in the
scenario is trauma by a blunt object

27. -Nelwan, Berti. Bahan Kuliah Blunt Force Trauma. 2018. Fakultas Kedokteran UMI.
-Rabindra Nath Karmakar. FORENSIC MEDICINE AND TOXICOLOGY: THEORY, ORAL & PRACTICAL. 2015. Kolkata(india): Academic Publishers. Pg.30. Accesed by google books.
CAUSATIVE AGENTSAbrasion
An abrasion is denuded skin caused by frictional force.
A wound may be either deep or superficial depending on the force and the coarseness of the surface which caused
the abrasion.
Side impact produces a moving abrasion: indicates direction and trace material (e.g. grit).
Abrasion over arms, forearms, breast, inner aspect of thigh, external genitalia of female suggest rape or attempted
rape.
Abrasion of prepuce or glans penis indicates forceful sex act or attempted penetration through narrow passage (vagina
or anus).
The possible cause of abrasion in the scenario is trauma by a
long blunt object with friction force

28. How is the severity /
degree of injury in
accordance with
applicable law?
6

29. Pasal 44
 Anyone committing physical violence within the home the ladder as referred to in
Article 5 letter a shall be criminalized with a maximum imprisonment of 5 (five) years
or a maximum fine of Rp 15.000.000,00
 In the case of the acts referred to in paragraph (1) result the victim gets sick or
severely injured, is punished by imprisonment a maximum of 10 (ten) years or a fine
of not more than Rp 30.000.000,00
 In the case of an act as referred to in paragraph (2) resulted the death of the victim,
shall be sentenced to a maximum imprisonment of 15 (fifteen) years or a maximum
fine of Rp 45,000,000.00
 In the case of the acts referred to in paragraph (1) shall be done by husband against
wife or otherwise that does not cause illness or obstacles to performing employment
or livelihood work or daily activities, shall be punished with imprisonment for a
maximum of 4 (four) month or a fine of not more than Rp 5.000.000,00

30. Criteria of Injury : Moderate
 Based on the scenario the wound is cathegorized into moderate injury
because of wounds cause illness or obstacles to run a job or job search.
 Article 351 KUHP
 Persecution/maltreatmet shall be subject to
imprisonment of a maximum of two years and
eight months or a fine of four thousand five
hundred rupiah

31. What is the definition of
domestic violence and the
types of domestic
violence?
7

32.  Any act against a person, especially a woman,
resulting in misery, or suffering physically,
sexually, psychologically, and / or neglecting a
household, including the threat of unlawful
conduct, coercion, or deprivation of liberty,
within the scope of households
What is
domestic
violence ?
•Law no. 23 of 2001, article 1, paragraph 1 (Law on the Elimination of Domestic Violence)
•Teaching Materials “Kekerasan Dalam Rumah Tangga (KDRT)” by dr. Djumadi Achmad, Sp.PA (K), DFM, Sp.F

33. TYPE OF DOMESTIC VIOLENCE
 Physical Abuse
 Acts that result in pain, illness, or
severe injury
 Psychic Abuse
 Acts that cause fear, loss of confidence,
loss of ability to act, feelings of
helplessness
•Law no. 23 of 2001, article 1, paragraph 1 (Law on the Elimination of Domestic Violence)
•Teaching Materials “Kekerasan Dalam Rumah Tangga (KDRT)” by dr. Djumadi Achmad, Sp.PA (K), DFM, Sp.F

34. TYPE OF DOMESTIC VIOLENCE
 Sexual Violence
 Sexual coercion in an unnatural way,
whether for husbands or for others for
commercial purposes, or for a
particular purpose
 Economic Violence
 Neglect that occurs within the
household, which by law is required
thereon.
•Law no. 23 of 2001, article 1, paragraph 1 (Law on the Elimination of Domestic Violence)
•Teaching Materials “Kekerasan Dalam Rumah Tangga (KDRT)” by dr. Djumadi Achmad, Sp.PA (K), DFM, Sp.F

35. How are the strategies for
handling victims of
domestic violence?
8

36.  Preventive approach
• Inculcating family's basic values ​​to
each family member
• Encourage and facilitate community
development
 Curative approach
• Takes the victim to a counselor or
psychologist
• Give strict sanctions to the
perpetrator and encourage the
offender to get closer to God
• The firmness of the government in
implementing the existing
regulations
Aflanie, Iwan. Dkk. 2017. Ilmu Kedokteran Forensik & Medikolegal. Cetakan 1 Jakarta: Rajawali Pers.

37. How is the prespective
Islam from the scenario?
9

38. Allah SWT says in Qs. an-Nisâ '[4]: 19:
"O ye who believe! It is not lawful for you to wear women by force and do not
prevent them from marrying and troubling them for taking back some of what you
have given him, when they commit a vile act of evil. And get along with them
properly. Then if you do not like them, (so be patient) because maybe you do not
like something, but Allah makes him a lot of good "(Surat an-Nisâ '[4]: 19).

39. The wife must obey the husband as long as the husband does not violate the
syara '. Prophet Saw states: "When a woman prays five times, fasts a month
(Ramadan), guards her cock and obeys to her husband, it is said to her: Enter
you into heaven from whichever door you like." Ahmad 1/191, in-shahih-kan
asy-Shaykh al-Albani rahimahullah in Shahihul Jami 'No. 660, 661).

40. THANK YOUSee you in the next panel