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Self-inflicted stab injury with abdominal evisceration: A case report

INTRODUCTION AND IMPORTANCE: Self-inflicted abdominal stab injury with an intention of self-harm is uncommon. Moreover, self-inflicted injury leading to avulsion of the colon has rarely been reported in the literature. We report a case of a 42-years-female with schizoaffective disorder who presented...

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Autores principales: Parajuli, Anuj, Mishra, Aakash, Ghimire, Roshan, Shrestha, Suman Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578032/
https://www.ncbi.nlm.nih.gov/pubmed/34749175
http://dx.doi.org/10.1016/j.ijscr.2021.106543
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author Parajuli, Anuj
Mishra, Aakash
Ghimire, Roshan
Shrestha, Suman Kumar
author_facet Parajuli, Anuj
Mishra, Aakash
Ghimire, Roshan
Shrestha, Suman Kumar
author_sort Parajuli, Anuj
collection PubMed
description INTRODUCTION AND IMPORTANCE: Self-inflicted abdominal stab injury with an intention of self-harm is uncommon. Moreover, self-inflicted injury leading to avulsion of the colon has rarely been reported in the literature. We report a case of a 42-years-female with schizoaffective disorder who presented with self-inflicted stab injury on the abdomen resulting in abdominal evisceration. PRESENTATION OF CASE: A 42-years-female with schizoaffective disorder (F25) for 10 years presented to the emergency department with multiple, self-inflicted injuries on the abdomen. A large free portion of the omentum and segment of the bowel were brought in a plastic carry bag. Examination revealed multiple transverse hesitation cuts in the epigastrium and a single deep penetrating transverse cut resulting in the evisceration of the omentum and colon. Intra-operatively, avulsion of a large portion of the greater omentum and missing segment of the mid transverse colon was observed. The patient underwent an immediate abdominal exploration and side-to-side colo-colic anastomosis along with diversion ileostomy. At three months following primary surgery, ileostomy closure was done. CONCLUSION: Patients with schizophrenia spectrum psychosis are at risk of self-harm and in our case a schizoaffective patient presented with self-inflicted injuries that required an emergency abdominal exploration and repair. This case highlights a multi-disciplinary approach for the management of these cases and mandates clinicians and caregivers to be more vigilant to restrict injuries in the future.
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spelling pubmed-85780322021-11-15 Self-inflicted stab injury with abdominal evisceration: A case report Parajuli, Anuj Mishra, Aakash Ghimire, Roshan Shrestha, Suman Kumar Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Self-inflicted abdominal stab injury with an intention of self-harm is uncommon. Moreover, self-inflicted injury leading to avulsion of the colon has rarely been reported in the literature. We report a case of a 42-years-female with schizoaffective disorder who presented with self-inflicted stab injury on the abdomen resulting in abdominal evisceration. PRESENTATION OF CASE: A 42-years-female with schizoaffective disorder (F25) for 10 years presented to the emergency department with multiple, self-inflicted injuries on the abdomen. A large free portion of the omentum and segment of the bowel were brought in a plastic carry bag. Examination revealed multiple transverse hesitation cuts in the epigastrium and a single deep penetrating transverse cut resulting in the evisceration of the omentum and colon. Intra-operatively, avulsion of a large portion of the greater omentum and missing segment of the mid transverse colon was observed. The patient underwent an immediate abdominal exploration and side-to-side colo-colic anastomosis along with diversion ileostomy. At three months following primary surgery, ileostomy closure was done. CONCLUSION: Patients with schizophrenia spectrum psychosis are at risk of self-harm and in our case a schizoaffective patient presented with self-inflicted injuries that required an emergency abdominal exploration and repair. This case highlights a multi-disciplinary approach for the management of these cases and mandates clinicians and caregivers to be more vigilant to restrict injuries in the future. Elsevier 2021-11-02 /pmc/articles/PMC8578032/ /pubmed/34749175 http://dx.doi.org/10.1016/j.ijscr.2021.106543 Text en © 2021 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Parajuli, Anuj
Mishra, Aakash
Ghimire, Roshan
Shrestha, Suman Kumar
Self-inflicted stab injury with abdominal evisceration: A case report
title Self-inflicted stab injury with abdominal evisceration: A case report
title_full Self-inflicted stab injury with abdominal evisceration: A case report
title_fullStr Self-inflicted stab injury with abdominal evisceration: A case report
title_full_unstemmed Self-inflicted stab injury with abdominal evisceration: A case report
title_short Self-inflicted stab injury with abdominal evisceration: A case report
title_sort self-inflicted stab injury with abdominal evisceration: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578032/
https://www.ncbi.nlm.nih.gov/pubmed/34749175
http://dx.doi.org/10.1016/j.ijscr.2021.106543
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