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A seemingly normal breakfast at a diner in Florida turned into a terrifying ordeal for a 63-year-old man and his wife. The man, who had recently undergone surgery, experienced a freak accident when a combination of coughing and sneezing caused his intestines to fall out of his body. According to the American Journal of Medical Case Reports, the man felt a wet sensation followed by a sharp pain in his abdomen. Upon lifting his shirt, he saw several inches of his bowel protruding from a recent surgical wound on his abdomen.1
Initially, the man’s instinct was to drive himself to the hospital. However, he quickly realized the severity of his condition and feared that moving might worsen the injury. His wife called for an ambulance instead. Paramedics arrived within five minutes and found a three-inch opening in his abdomen with large amounts of bowel protruding through it. Despite the severity of the injury, the bleeding was minimal. The paramedics were initially unsure of the best treatment as their protocols did not cover such an unusual situation.
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Emergency Medical Response
The paramedics knew they needed to keep the exposed intestines moist to prevent further complications. They covered the intestines with saline-soaked gauze and wrapped the man’s abdomen before transporting him to the hospital. This quick thinking was crucial in preventing additional damage to the exposed bowel. Upon arrival at the hospital, the man was rushed into surgery where multiple doctors evaluated his condition.
Surgical Intervention
In the operating room, surgeons discovered that despite the shocking appearance, there was no damage to the man’s bowel. They carefully placed the intestines back inside the abdominal cavity and closed the wound with both internal and external stitches.2 The patient was then monitored closely for several days in the hospital to ensure there were no further complications.
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Background and Complications
Two weeks prior to this incident, the man had undergone a successful surgery for complications related to a previous battle with prostate cancer. This surgery involved the removal of the bladder, a procedure known as cystectomy, which is typically performed for bladder cancer but can also be necessary for other conditions like radiation cystitis. Post-operative wound dehiscence, where the surgical wound reopens, is a known complication of such surgeries, but bowel evisceration through the wound is extremely rare.
Medical Insights
Wound dehiscence can occur due to increased intra-abdominal pressure caused by activities such as coughing or sneezing. In this case, the man’s forceful sneeze and cough likely led to the wound reopening and his intestines protruding through the surgical site. The medical literature on bowel evisceration following cystectomy is sparse, making this case particularly notable. A PubMed search revealed only a handful of similar cases.
Recovery
Following the surgery to repair his wound, the man recovered without further issues and was discharged from the hospital after six days. His case highlights the importance of prompt and appropriate emergency response to unusual medical situations. It also underscores the need for medical personnel to be trained in handling rare but serious complications like bowel evisceration.
This incident serves as a stark reminder of the potential complications that can arise even after seemingly successful surgeries. It also illustrates the resilience of the human body and the critical role of emergency medical services in managing life-threatening situations.
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Sources
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