Emergency Trauma Laparotomy

A 32-year old male patient suffered an accidental fall at his home, and sustained an injury to the left side of his abdomen after he slipped and hit the edge of the bed at mid-night. A few hours later, the patient collapsed in the washroom. He was rushed to the emergency department at Aster hospital, Al Qusais.

The emergency department team attended the patient immediately. During his assessment in the resuscitation room he was very drowsy, dehydrated with a heart rate of 140 beats/min and BP of 80/50mmHg. His haemoglobin was 7 (g/dl). He was also complaining of severe abdomen pain with a pain score of 10/10.

Dr. Pradeep Kumar, immediately recognized the patient is in shock secondary to blunt abdomen injury. Resuscitation was started and an emergency ultrasound scan in the ER department (FAST) was performed by him. Dr. M. Khalid Mohiuddin, the on-call surgeon was informed immediately, who then identified that the patient needed lifesaving intervention (laparotomy). This was determined following a CT scan of the patient’s abdomen pelvis which showed Grade 3 spleenic rupture. Ideally, traumatic injuries are dealt in government hospitals in UAE, but given this patient’s clinical condition, it was not safe for him to be transferred to trauma center. Therefore, he needed an early intervention at Aster Hospital, Al Qusais.

Dr. Khalid performed life saving laprotomy and spleenectomy. Intra-operatively patient was found to have 2ltrs of blood in his abdominal cavity with ruptured spleen. Following the operation, the patient was monitored in ICU and later discharged from the hospital after 5 days, without any complications.

Dr. Khalid Mohiuddin
Consultant Laparoscopic General and Colorectal Surgeon
Dr. Pradeep Kumar
General Practitioner
Aster Hospital, Al Qusais