Case Archive
 
General Surgery, Trauma Surgery
Ref. # 34938

A 33 year old West Virginia man was brought to the ER with a gunshot wound to the abdomen. He underwent an exploratory laparotomy, which revealed multiple wounds to the jejunum with exit wounds at the right flank. A resection and reapproximation were performed. The post-op course was complicated by, in turn: respiratory arrest: reintubation; renal failure; self-extubation; and a second respiratory arrest and reintubation. The patient was transferred to a major hospital where he was diagnosed with abdominal sepsis. He underwent another exploratory laparotomy, which revealed a perforation of the second and third portions of the duodenum. The patient continued to deteriorate and was pronounced brain dead five days after the initial injury. A medQuest general surgeon specializing in trauma reported that at first hospital the surgeon negligently missed the duodenal injury and failed to explore the hematoma in the retroperitoneal area, which he noted in his OR report. Furthermore, the post-op care was far below acceptable standards.




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