Case Presentation: Size Doesn't Matter - How can a metal shard get you to the OR in one afternoon?-Handout: Case Presentation: Size Doesn't Matter

Handout: Case Presentation: Size Doesn't Matter - How can a metal shard

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This document is a case presentation discussing a patient who suffered a penetrating wound to the abdomen from a metallic object. The patient, a 31-year-old male, presented with a laceration on the anterior abdominal wall and complained of abdominal pain. Initial surveys showed that the patient's airway and breathing were intact, but he had a hemostatic wound in the right lower quadrant of the abdomen, among other findings. Further imaging with a CT scan revealed multiple injuries, including a 2cm laceration to the posterolateral wall of the inferior vena cava (IVC) and a right proximal ureteral injury.<br /><br />The patient underwent an emergent operative exploration where the injuries were repaired. The IVC laceration was primarily repaired using prolene sutures, while the right ureteral injury was closed over a double J stent. The abdominal cavity was re-explored, and additional injuries were ruled out. The patient had a post-operative course that included extubation in the operating room, close monitoring in the ICU, and subsequent removal of drains. Follow-up procedures were planned to assess the ureteral injury and monitor the patient's recovery.<br /><br />The case presentation also discussed performance improvement opportunities, such as triaging trauma activations, intraoperative fluid resuscitation, and ongoing education for staff. The importance of preparation and continuing education in managing trauma patients was emphasized. The document concluded with acknowledgments and references to resources used in the case presentation.<br /><br />Overall, the case presentation highlights the complex nature of multi-system injuries caused by a single shard of metal and emphasizes the interdisciplinary approach and preparation required to manage such cases successfully.

Keywords

penetrating wound

abdomen

metallic object

laceration

abdominal pain

hemostatic wound

CT scan

injuries

inferior vena cava

ureteral injury