Diners in Florida were left horrified when a man sneezed during breakfast at a diner and accidentally expelled his intestines all over the table.
A 63-year-old man, who had recently undergone a common digestive surgery, had just had his stitches removed that morning and decided to celebrate with a meal after spending 15 days in hospital. He had recently had a cystectomy, a surgical procedure to remove the entire urinary bladder as a preventative measure against certain cancers.
Despite being advised to take it easy, he didn't realize that something as simple as a sneeze could cause him to lose his large intestine, which fell out of his surgery wound and hadn't quite healed enough to withstand the pressure.
The case was documented in the American Journal of Medical Case Reports , where the authors noted that "Evisceration is a rare complication of abdominal surgery."
Even doctors were taken aback by this unusual case - but despite its rarity, they do urge caution for patients, reports the Mirror US . "During breakfast, the man sneezed forcefully, followed by coughing. He immediately noticed a 'wet' sensation and pain in his lower abdomen. Looking down, he observed several loops of pink bowel protruding from his recent surgical site," the researchers wrote.
"He later related that he was unsure of how to proceed, so he covered the exposed intestines with his shirt. He initially decided to drive himself to the hospital, but concerned that changing his position might injure his bowel, his wife requested an ambulance," the study continues in the case presentation portion.
That morning, the man returned to the Urology clinic, where doctors found his wound well-healed and removed the staples. Following this, he and his wife celebrated over breakfast.
However, during their meal, the man sneezed forcefully, triggering a bout of coughing. While 'wound dehiscence' is a recognised complication, evisceration through the abdominal surgical site after cystectomy "is poorly described in the medical literature," according to the authors of the study.
It's crucial to understand all potential side effects so that proper treatment can be provided. Sadly, in this instance, the man wasn't sure how to handle the situation and even considered driving himself to the emergency room.
Unfortunately, the responding paramedic also had no established protocol for handling such an eerie incident.
The medics who brought this case to light suggest that Emergency Medical Services medical directors might want to adopt the abdominal evisceration guidelines from Tactical Combat Casualty Care. These include "including controlling visible bleeding, addressing gross contamination by rinsing the bowel with sterile saline or sterile water, covering the exposed bowel with a 'moist, sterile dressing or a sterile water-impermeable covering,' and irrigate these dressings as needed with additional sterile fluid."
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