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Intestinal Perforation
Discussion in 'All Categories' started by Kretic Anther - Jun 2nd, 2014 4:59 am.
Kretic Anther
Kretic Anther
Dear Doctor,

A gynecological surgeon performed total laparoscopic hysterectomy on my wife. In her O.T. Note she has written, dense adhesions were encountered throughout the operation, which required lysis. On postoperative first day, my wife developed increasing pain, at the umbilical port site. On day 2, she developed leukocytosis, and nasogastric tube was introduced with increasing nasogastric output.

Abdominal CT was done on day 3 showed free air under diaphragm. The gynecologist interpreted this as normal and secondary to the recent laparoscopy with CO2. Progressive erythema around the umbilicus increased and pain keep on increasing. A repeat abdominal CT was done 5th day of surgery which showed left subphrenic along with a huge abdominal fluid collections in the abdomen of my wife, strongly suspicious for sub-diaphragmatic abscesses. The radiologist of the same hospital interpreted this as a bowel perforation.

After that much suffering I became very upset and requested transfer to some tertiary care hospital. There in new hospital, the receiving General surgeon performed an immediate laparotomy, locating a perforated transverse colon. He did a long right hemi colectomy with primary anastomosis. After a hard 21 days of postoperative course, my wife anyhow recovered. Please advice me how can I do medicolegal case for compensation as it is fault of surgeon.

With regard -Anther
re: Intestinal Perforation by Martin - Jun 2nd, 2014 5:10 am
Dear Anther

The Gynecologist can be sued for negligence in 3 areas:

1. Neglecting to convert to a wide open hysterectomy when he encountered a hostile abdomen.

2. Injuring the transverse colon throughout the lysis of adhesions.

3. Failing to timely diagnose the colon perforation, especially in light of the misinterpretation from the CT findings.
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