Teaching image withheldThe image will be revealed when it becomes clinically available in the case.
Operative photograph obtained during exploratory laparotomy after abdominal entry, showing exposed small bowel with multiple penetrating injuries and leakage of enteric contents into the operative field. • TEACHING IMAGE
Penetrating Abdominal Trauma With Multiple Small-Bowel Perforations
SCENARIO
A patient arrives after a gunshot wound to the abdomen with hypotension and clinical concern for intra-abdominal hemorrhage and contamination. After immediate airway and circulation support with blood-product resuscitation, the trauma team proceeds directly to the operating room for emergent exploratory laparotomy. The uploaded image becomes available after the abdomen is opened and the small bowel is examined, showing multiple perforations with gross enteric leakage.