What a belly ache
- By: Steven Kennish, Shireen McKenzie
You are a medical student attached to a general surgery firm. While you are shadowing the senior house officer he is contacted for a trauma case; you accompany him to the resuscitation bay of the emergency department.
The trauma team awaits the arrival of a patient with an abdominal stab wound. You stand clear and observe the ordered and calm way in which the patient is dealt with on arrival. After a short period of initial assessment and resuscitation, consent is given for surgery and the patient is transferred to the acute theatre, where he is anaesthetised and prepared for an operation (fig 1).
Wounds that do not penetrate the abdominal cavity can usually be irrigated and closed under local anaesthesia; this is followed by a period of observation. If a gloved finger follows a track into the abdominal cavity the patient requires a laparotomy to assess any underlying damage.