In 01. 11.17., 29 y/o patient S.A. was brought to Emergency Department of MC Erebouni with stab wounds in the left hemithorax, shock III°.
Primary examination and computed tomography (CT) were carried out urgently, which established that the patient had two penetrating stab wounds in the left hemithorax with pulmonary, the left ventricular, diaphragm and abdominal injuries, marked hemothorax, hemopericardium and hemo pneumoperitoneum.
The patient, as a matter of urgency, for life-saving purposes was transferred to an operating-room.
The team of surgeons under supervision of the Head of Thoracic Surgery Department Prof. A. Hovhannisyan (MD), senior surgeon of General & Laparoscopic Surgery Department Dr. A. Meliqyan (MD), thoracic surgeon Dr. G. Soghomonyan and surgeon Dr. T. Arakelyan performed the most complicated surgery : immediate thoracotomy, suture of the left ventricular stab wound, restoration of lung integrity, hemostasis, diaphragm repair. Then in a second stage midline laparotomy was performed, during which it was found that there was transthoracic injury of the anterior surface of the stomach with the formation of intraventricular large hemorrhage. Closure of stomach wound, control bleeding, diaphragm repair, debridement and drainage of abdominal wound were carried out.
Simultaneously , intraoperatively ,refusion of blood obtained from pleural cavity was performed.
Postoperative period goes in accordance with the trauma and surgical interventions. After restoration of basic vital signs and intensive therapy, the patient from ICU ( Intensive Care Unit) was transferred to the Surgery Clinic for further treatment.
Thus, the unique multidisciplinary therapeutic approach aimed at saving human life was undertaken, as simultaneous left ventricular stab wounds, lung and stomach injuries in most cases lead to a lethal outcome.
