Perioperative complications in a patient with sickle cell disease following penetrating trauma

Abstract

A 26-year-old male with documented SCD (Hgb SS)presentedtotheEmergencyDepartmentwithmulti-ple gun shot wounds. The patient had bullet woundsintheleftlowerquadrantandtheleftflankaswellastwo wounds to the left upper extremity (with anobvious deformity) and a single wound to the rightlower extremity (with the bullet palpable in thesubcutaneous tissue). The patient was in distress,tachycardic, diaphoretic with a rigid abdomen. Achest roentegram was reported as being normal,followingwhich,anexploratorylaparotomywasper-formed. Findings at laparotomy were four perforat-ing small bowel injuries with a small serosal tear inthe left colon. A small bowel resection (including allfour injuries and comprising of 50 cm of proximalileum)withprimaryanastomosiswasperformed.Thecolonic serosal injury was also oversewn. Total esti-mated blood loss was 300 cm