Thursday, May 21, 2009

Case Files: Stab Wound

Presenting Scenario: 48 year old patient presents with a 2 inch laceration on the right lower quadrant of his abdomen. Patient reports that suspects the stabbing occurred that morning around 4am...it is now 1pm at presentation, due to "dizziness". Patient is lying comfortably on bed, seems to be in no apparent distress, but keeps asking for a telephone to call family.

Trauma Room Decisions:
The patient refuses to allow the Doctors to insert their finger into the wound and explore how deep it is. Patient becomes combative any time we try. This leaves us with a difficult decision. Either we take patient to CT scan to see if there are any deep injuries to internal organs that could result in a sudden change in status, or we just rush patient up to the OR (Operating Room) and start the operation there under anesthesia. Decision was made to take patient up to the OR.

Diagnosis:
Superficial wound. Yes, we rushed the patient to the OR, put patient under general anesthesia, and then were able to stick our finger in the wound...to find nothing. The wound barely even got through any fat layer.

Surgical Procedure:
Stitch up the wound.

Results:
Patient is fine. Was offered alcohol and drug counseling due to addictions, but otherwise, is fine.

Note: Picture is not from the actual patient's wound.

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