Evisceration is a rare complication of abdominal surgery. This case report describes small bowel evisceration through a healed cystectomy surgical site after sneezing and coughing. Perspectives from the emergency responders, the patient, and his surgeons are discussed. When evisceration occurs, patients may be unsure of how to protect their exposed intestines. First medical responders may experience anxiety with initial management due to a distressing presentation and unfamiliarity with the condition. Surgeons must carefully protect the bowel, reduce it into the abdomen, inspect it for injury, prevent infection, and repair the dehisced wound
| [1] | Aminoltejari, K. and Black, P.C., “Radical cystectomy: a review of techniques, developments and controversies,” Translational Andrology and Urology. 9 (6). 3073-3081. Dec 2020.View Article PubMed |
| [2] | Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D.M., Forman, D. and Bray, F. “Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012.” International Journal of Cancer. 136 (5). 359-386. Mar 2015.View Article PubMed |
| [3] | Rai, B.P., Bondad, J., Vasdev, N., Adshead, J., Lane, T., Ahmed, K., Khan, M.S., Dasgupta, P., Guru, K., Chlosta, P.L. and Aboumarzouk, O.M. “Robotic versus open radical cystectomy for bladder cancer in adults.” Cochrane Database of Systematic Reviews. 4 (4). Apr 2019.View Article PubMed |
| [4] | Aftreth, O.P., Tenggardjaja, C.F. and Reyblat, P. “Cystectomy for Benign Indications.” Current Urology Reports. 23(9). 195-201. Sep 2022.View Article PubMed |
| [5] | Shabsigh, A., Korets, R., Vora, K.C., Brooks, C.M., Cronin, A.M., Savage, C., Ganesh, R., Bochner, B.H., Dalbagni, G., Herr, H.W. and Donat, S.M. “Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology.” European Urology. 55(1). 164-174. Jan 2009.View Article PubMed |
| [6] | Xue, G., Liu, Y., Ji, X. and Zhang, H. “Wound dehiscence in enhanced recovery after open radical cystectomy: A meta-analysis.” International Wound Journal. 20 (7). 2634-2639. Sep 2023.View Article PubMed |
| [7] | Meyer, C.P., Rios Diaz, A.J., Dalela, D., Hanske, J., Pucheril, D., Schmid, M., Trinh, V.Q., Sammon, J.D., Menon, M., Chun, F.K., Noldus, J., Fisch, M. and Trinh, Q.D. “Wound dehiscence in a sample of 1776 cystectomies: identification of predictors and implications for outcomes.” BJU International. 117 (6B). E95-E101. Jun 2016.View Article PubMed |
| [8] | Riesberg, J.C., Gurney, J.M., Morgan, M., Northern, D.M., Onifer, D.J., Gephart, W.J., Remley, M.A., Eickhoff, E., Miller, C., Eastridge, B.J., Montgomery, H.R., Butler, F.K. and Drew, B. “The Management of Abdominal Evisceration in Tactical Combat Casualty Care: TCCC Guideline Change 20-02.” Journal of Special Operations Medicine. 21 (4). 138-142. Winter 2021.View Article PubMed |
