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  2. What a belly ache
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Student Education

What a belly ache

BMJ 2006; 332 doi: https://doi.org/10.1136/sbmj.060250 (Published 01 February 2006) Cite this as: BMJ 2006;332:060250
  1. Steven Kennish, senior house officer1,
  2. Shireen McKenzie, specialist registrar2
  1. 1Professorial Surgical Unit, Leeds General Infirmary
  2. 2Academic Department of General Surgery, Leeds General Infirmary

You are a medical student attached to a general surgery firm. While you are shadowing the senior house officer he is contacted for a trauma case; you accompany him to the resuscitation bay of the emergency department.

The trauma team awaits the arrival of a patient with an abdominal stab wound. You stand clear and observe the ordered and calm way in which the patient is dealt with on arrival. After a short period of initial assessment and resuscitation, consent is given for surgery and the patient is transferred to the acute theatre, where he is anaesthetised and prepared for an operation (fig 1).

Fig 1

Patient prepared for laparotomy

Questions

  1. What is the ordered approach for the assessment and resuscitation of trauma patients?

  2. Why was this patient taken to theatre withoutpreoperative imaging?

  3. The patient's head is towards the top left of the picture under the drape. The umbilicus is pooled with betadine preparation solution. Describe the location of the injury and list the organs and structures the surgeons are most worried about?

Answers

  1. The advanced trauma life support method.1

  2. The knife required removal under surgical control and the patient was haemodynamically stable and adequately …

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