Introduction
In trauma surgery, timing is everything. The following case highlights how rapid assessment, precise diagnosis, and timely surgical intervention saved the life of a young patient who sustained a severe abdominal injury due to an accidental air fire incident involving a metal hook (commonly referred to as Khili).
Case Overview
- Patient: 25-year-old male
- Incident: Accidental air gun discharge caused penetration of a metal hook (Khili) through the abdominal wall
- Initial Assessment: The patient arrived in a hemodynamically unstable condition with signs of internal bleeding.
Imaging Findings
A contrast-enhanced CT scan revealed:
- A foreign body traversing the abdominal wall
- Injury to mesenteric vessels
- Active intra-abdominal bleeding
- Suspicion of associated bowel injury
These findings prompted the need for urgent surgical intervention.
Emergency Surgical Management
The patient was swiftly shifted to the operating theatre for an exploratory laparotomy. Intraoperative findings included:
- Approximately 1.5 liters of hemoperitoneum (free blood in the abdomen)
- Active bleeding from mesenteric vessels
- Penetration of a metal hook through the abdominal wall
- Injury to the colon
Surgical procedures performed:
- Control of mesenteric bleeding
- Removal of the metallic foreign body (Khili)
Segmental colon resection with primary anastomosis
Outcome
Thanks to timely surgical intervention:
- Hemorrhage was effectively controlled
- The colon was repaired and restored with continuity
- The patient was stabilized postoperatively and shifted to the ICU for monitoring
This was a true life-saving surgery, where time-critical decision-making played a crucial role in the patient’s survival and recovery.
Discussion
Penetrating abdominal trauma due to foreign objects—especially metal projectiles—is rare but potentially fatal. Injuries to mesenteric vessels can result in massive intra-abdominal bleeding within minutes.
Key takeaways:
- Early diagnosis with high-resolution imaging (CT scan) is crucial
- Rapid decision-making and availability of surgical expertise directly impact outcomes
- Multidisciplinary teamwork in the emergency room and operation theatre saves lives
Conclusion
This case demonstrates the power of prompt surgical intervention in complex abdominal trauma. It underscores the importance of surgical preparedness and reinforces the critical role of trauma care in saving lives, especially in unusual yet severe injuries such as this.
📞 Need Emergency Surgical Help in Surat?
If you or your loved ones are ever faced with gastrointestinal emergencies, Dr. Dharmesh Dhanani, a trusted gastrointestinal and trauma surgeon in Surat, is available 24×7 for expert consultation and intervention.
📍 Kiran Hospital, Surat
📞 +91-9913400034
