Dony Ruswendro
Department of Surgery Panglima Sebaya Regional Hospital, Paser, East Borneo, Indonesia

DOI: https://doi.org/10.19184/ams.v10i1.45271

Abstract

Background: Penetrating trauma is often caused by armed violence, both firearms and sharp weapons, and occurs in urban civilian populations. Penetrating trauma is responsible for 15%-45% of injuries to civilians. Aims: The aim of this paper is to present a case of intestinal evisceration and hypovolemic shock due to penetrating abdominal trauma that occurred in an elderly patient in a rural area. This paper also provides a discussion of the importance of adequately treating life-threatening emergencies before the patient is referred to hospital. Case Report: In this case, penetrating trauma occurred in an elderly patient due to an abdominal stab wound caused by a palm sickle when harvesting palm fruit. The location of the incident was in a rural oil palm plantation area and far from the hospital. Limited resuscitation facilities and a lack of trained emergency staff at the public health center where the patient was first treated, resulted in initial treatment being less than optimal and inadequate. This resulted in the patient coming to the hospital in a state of hypovolemic shock. Conclusions: The penetrating abdominal trauma that occurred in this patient was accompanied by intestinal evisceration and hypovolemic shock which was an absolute indication for immediate laparotomy exploration. The patient's comorbidities in the form of chronic heart failure and the patient's elderly age need to be taken into consideration and attention to prevent initial and subsequent complications. After laparotomy, the patient was able to survive and recover well without any complications.

Keyword: Penetrating abdominal trauma, intestinal evisceration, laparotomy.

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