A 63-year-old man had a bizarre incident during breakfast at a diner when he sneezed and coughed so hard that his small intestine came out through a previous surgical site. His bowels were exposed and protruding, leading to a medical emergency.
The man’s quick thinking to cover his intestines with his shirt and his wife’s decision to call an ambulance instead of driving to the hospital likely saved his life. Paramedics kept the area moist with saline-soaked pads until he reached the hospital.
In the emergency room, a team of medical professionals, including three urologic surgeons, performed immediate surgery to put the bowel back into the abdominal cavity. They carefully examined the bowel for any injuries, cleaned the area, and closed the wound securely with sutures. Fortunately, the patient recovered well with no signs of bowel injury and was discharged in good health.
This unusual case occurred two weeks after the patient underwent a cystectomy to remove his entire urinary bladder due to cancer. While wound dehiscence is a common post-operative complication, bowel evisceration through the abdominal wall after a cystectomy is extremely rare.
According to a recent report on this case, incidents of bowel evisceration after cystectomy are uncommon and not well understood. This highlights the importance of first responders and medical professionals being prepared for rare but serious complications following abdominal surgeries. It also suggests that emergency medical protocols may need to include specific guidelines for handling bowel evisceration to ensure the best possible outcomes for patients.
The report recommends incorporating guidelines for abdominal evisceration from Tactical Combat Casualty Care, such as controlling visible bleeding, rinsing the bowel with sterile saline or water to address contamination, covering the exposed bowel with sterile dressing or water-impermeable covering, and irrigating the dressings as necessary with sterile fluid.
This case study was published in the American Journal of Medical Case Reports, shedding light on the need for medical professionals to be ready for unexpected complications and to have clear protocols in place to handle such situations effectively.
