Life-Saving Emergency Trauma Surgery at Bombay Gastro & Cancer Institute, Bathinda
A 35-year-old male was brought to the emergency department late at night following a high-speed road traffic accident (RTA). He had sustained a catastrophic crush injury to the abdomen with extensive loss of the abdominal wall extending from the anterior abdominal wall across the left flank to the back.
On arrival, the patient was critically injured with complete evisceration of the abdominal contents, with multiple loops of small intestine lying outside the abdominal cavity through a massive traumatic defect. He was in severe pain and required immediate resuscitation before emergency surgery.
Emergency Surgical Management
The patient was immediately taken to the operating theatre, where Dr. Raman Garg, Consultant Surgical Gastroenterologist, Advanced GI, Laparoscopic & HPB Surgeon at Bombay Gastro & Cancer Institute, Bathinda, performed an emergency exploratory laparotomy.
During surgery, a jejunal perforation was identified in addition to the extensive traumatic abdominal wall disruption. The perforation was repaired, the abdominal cavity was thoroughly irrigated to reduce contamination, and meticulous reconstruction of the abdominal wall was performed to restore abdominal integrity while preserving viable tissue.
The operation successfully controlled contamination, repaired the bowel injury, and stabilized the abdominal wall despite the extensive tissue loss.
Postoperative Recovery
Despite the severity of the injury, the patient made an excellent recovery.
- Gradual return of bowel function.
- No major postoperative complications.
- Progressive wound healing.
- Discharged in satisfactory condition on the 10th postoperative day.
Advanced Wound Reconstruction
Because of the extensive soft tissue loss, the patient continued regular follow-up for advanced wound management.
The remaining wound was treated with Negative Pressure Wound Therapy (VAC Therapy), promoting rapid granulation tissue formation, reducing wound contamination, and accelerating wound contraction.
Over the following weeks, healthy granulation tissue developed remarkably well, and the wound became suitable for definitive split-thickness skin grafting, representing another major milestone in the patient's recovery.
Why This Case Is Important
Complete traumatic disruption of the abdominal wall with bowel evisceration is one of the most devastating emergencies encountered in trauma surgery. Such injuries are associated with an extremely high risk of severe contamination, bowel injury, overwhelming infection, abdominal compartment syndrome, multiple organ failure, and death.
Successful treatment requires rapid resuscitation, immediate surgery, meticulous bowel repair, abdominal wall reconstruction, and advanced postoperative wound care.
This case demonstrates Dr. Raman Garg's expertise in managing complex abdominal trauma, bowel injuries, abdominal wall reconstruction, perforation surgery, and emergency gastrointestinal surgery, leading to an excellent outcome despite a potentially fatal injury.
Advanced Emergency Gastrointestinal and Trauma Surgery by Dr. Raman Garg
Dr. Raman Garg is a leading Surgical Gastroenterologist in Bathinda, with expertise in the management of abdominal trauma, intestinal perforation, bowel injuries, perforation peritonitis, intestinal obstruction, colorectal diseases, liver and pancreatic disorders, gallbladder diseases, gastrointestinal cancers, abdominal wall reconstruction, and advanced laparoscopic surgery.
Patients from Bathinda, Punjab, Haryana, Rajasthan, and neighbouring states seek his expertise for complex emergency gastrointestinal surgery, hepatopancreatobiliary (HPB) surgery, colorectal surgery, trauma surgery, and minimally invasive surgical procedures.
Patient: 35-year-old Male
Diagnosis: Severe Road Traffic Accident (RTA) with Extensive Traumatic Abdominal Wall Loss, Complete Bowel Evisceration, and Jejunal Perforation
Procedures Performed: Emergency Exploratory Laparotomy, Repair of Jejunal Perforation, Abdominal Wall Reconstruction, and Postoperative Negative Pressure Wound Therapy (VAC Therapy)
Operating Surgeon: Dr. Raman Garg, Surgical Gastroenterologist, Advanced GI, Laparoscopic & HPB Surgeon, Bombay Gastro & Cancer Institute, Bathinda
Outcome: Successful emergency reconstruction with excellent postoperative recovery and discharge on the 10th postoperative day. On follow-up, the wound developed healthy granulation tissue and became suitable for definitive skin grafting.
About Dr. Raman Garg
Dr. Raman Garg is a Consultant Surgical Gastroenterologist, Advanced GI, Laparoscopic and HPB Surgeon at Bombay Gastro & Cancer Institute, Bathinda. He specializes in gastrointestinal cancer surgery, liver, pancreas and bile duct surgery, colorectal surgery, hernia surgery, upper GI surgery, emergency abdominal surgery, and advanced minimally invasive procedures.
Patient identity has been withheld to maintain confidentiality. This case is shared for educational purposes with appropriate consent and privacy safeguards.
