Traumatic Injury to the Abdomen & Wall

Traumatic injury to the bowel requires quick and accurate diagnosis and management. Time is of the essence when dealing with a patient with trauma. The patient will need to be stabilized and resuscitated to maintain and restore the functioning of vital organs. 

Traumatic injury to the abdomen is an emergency. This is a complex situation where a methodical approach following the principles of advanced trauma resuscitation protocols needs to be followed. Patients with trauma to the abdomen can have complex injuries involving solid organs and hollow viscus. There could be bleeding in the abdomen which requires prompt recognition and correction. Here we discuss a young adult who presented to the emergency department with multiple stab wounds to the abdomen and with very low blood pressure and in extremely critical condition. 

In the emergency room, the patient was immediately resuscitated as per protocols and stabilized. Prompt recognition of external injuries and stopping any external blood loss was a priority. He was immediately taken to have a computed tomography for evaluation of his injuries. During all this time his resuscitation continued and was being stabilized. He was accompanied by MH Surgery Clinic Surgeons making sure he remained stable and resuscitated. 

All investigation was reviewed and was recommended surgery for hollow viscus injury and intrabdominal bleeding that required prompt control. He was found to have multiple stab wounds to the small bowel and injury to the blood flow of the small bowel. The bleeding was controlled without compromising the small bowel there by was saving the bowel. There was no resection that was required. Multiple small injuries were controlled and repaired. All this was performed via a Minimally Invasive Advanced Surgery technique. He also had a complex injury to the abdominal wall. As we are well trained in complex surgeries he also underwent a complex hernia repair of the abdominal wall thereby preventing future complications like hernias. The patient recovered extremely well and remained with significant low pain and was discharged home. 

Trauma is the leading cause of death under the age of forty. Of all traumatic deaths, abdominal trauma is responsible for nearly ten percent of deaths. More than 50% of splenic injuries, 80% of liver injuries, and virtually all renal injuries are managed non-operatively. To have better outcomes patients need to be evaluated and managed at a Complex Surgery Center like the one we have at MH Surgery Clinics.