This patient entered the ER suffering from severe abdominal pains. He also had an uncontrollable urge to vomit, but for the rest he seemed fine (whatever this means). Still, his condition suddenly deteriorated so fast that he needed to be opened up.
His wife would wait for her husband in the hospital — the surgeon had told her that it probably was some banal stomach infection, so she shouldn’t be worried.
My girlfriend was a trainee at the time, and assisted the surgeon on call in the open surgery.
But what they saw when he was opened up, was besides unexpected, also beyond bleak. His bowel was almost completely black, and both the surgeon and his trainee knew right away what the diagnosis was. They also knew there was nothing they could do.
Bowel gangrene.
An irreversible condition (also known as “bowel infarction”) caused by insufficient blood flow. The patient’s bowel had essentially died, and his entire being was going down with it. It was the very first time my girlfriend had seen a bowel infarction, and hopefully it was also the very last time.
While they closed the patient, the surgeon and trainee were very quiet because they were facing two new realities: the first one was that the patient would never wake up again, and he only had a couple of hours left. The second one was that his wife was patiently sitting in the waiting room —
And she needed an update.
SOURCES: medical image by dr. Haitham Alfalah, CC BY-SA 3.0, via Wikimedia Commons. (It shows a bowel obstruction in a 30-year-old patient.)