Penetrating abdominal trauma

Ashley JR, Burczak KW, Cotton BA, Clements TW.  Br J Surg 2024; 111: 2024, znae168. Comment: Most patients who die have multiple injuries.

Marguerite Barnard, General Surgery Registrar, University of Pretoria, South Africa dr.margueritebarnard@gmail.com

As I scrubbed out from a hernia repair approaching midnight, I had an urgent call from Trauma Resus – “Dr. Barnard, there’s a stabbed heart.”  As my heart also skips a beat I remember, this is what we’ve been trained to do.  I let anaesthesia know to keep the OR empty, and that the scrub team should get a thoracotomy set ready while I rush to an assessment in Casualty. I find a young man with a precordial stab wound, and all of Beck’s triad (hypotension; elevated systemic venous pressure, often with jugular venous distention; muffled heart sounds) staring back at me, just like in a textbook.  Minutes later, we’re rolling into the OR, transfusion protocol activated, the scrub-sisters already opening sterile drapes. 

Karim Brohi FRCS FRCA

Karim Brohi shares why he became a trauma surgeon.