A man was eating breakfast with his wife when a cough and sneeze at the same time left him with a freak injury.
The Florida native’s colon exploded, causing his intestines to fall out of his body.
The 63-year-old noticed a ‘wet’ sensation followed by sharp pain. When he lifted his shirt he saw several inches of bowel were sticking out of his surgical wound.
He had recently had abdominal surgery but doctors insisted earlier that day his incision was ‘well-healed.’
His wife called an ambulance and upon arrival, paramedics said they observed a three-inch opening with ‘large amounts of bowel‘ protruding through it.
A Florida man’s colon exploded after coughing and sneezing at the same time (stock image)
He was immediately rushed to the hospital where surgeons were able to successfully return his bowel into his abdomen.
After recovering in the hospital for six days, the man was sent home and experienced no further complications.
His case is detailed in American Journal of Medical Case Reports.
This rare but serious complication of surgery is also called disembowelment and occurs when a patient’s internal organs protrude through an incision because of wound dehiscence, the reopening of a surgical site.
A study found wound dehiscence – the reopening of a surgical site – is estimated to occur in up to three-in-100 people who have had abdominal and pelvic surgeries, but can occur in up to 10 percent of elderly patients.
It can be deadly for four-in-10 patients due to excessive blood loss, prolonged severe pain or injury to the organs that have been exposed.
Experts, including those in the case report, cite coughing as a prominent risk factor for the complication, and authors of the report concluded: ‘Coughing was likely the cause in our case.’
The left illustration is from the patient’s case report depicting how the man’s bowels were protruding through the wound in his abdomen. The right illustration depicts the man’s incision after doctors repaired his evisceration
When it does occur, it must be treated with surgery to replace organs into the abdomen and close the open wound.
A sterile saline covering should also be put on eviscerations to keep the exposed organs moist until surgery can be performed.
Two weeks before the incident, the Florida man underwent surgery for complications resulting from a previous battle with prostate cancer, including a cystectomy, a surgery in which the bladder is removed.
The surgery was successful and doctors sent the patient home ‘in good condition.’
On the morning of the medical emergency, the man had his wound site examined and had sutures removed. He and his wife then went to breakfast to celebrate his clean bill of health.
After he noticed his internal organs coming out of his abdomen, the man quickly covered the injury with his shirt and was going to drive to the hospital.
However, he decided against that for fear it would exacerbate the injury. So his wife called 911.
The case report said an ambulance arrived four minutes later and while the man’s shirt was soaked with bodily fluid, paramedics observed minimal bleeding.
Never having faced such an injury, the case report said the paramedic was ‘unsure of the best treatment’ as routine protocols did not have guidelines for treating evisceration.
However, she did know the intestines needed to be kept moist so she covered them in saline and wrapped gauze around the man’s abdomen before taking him to the hospital.
Upon arrival, the patient was rushed to the operating room where three doctors examined the bowel, saw no evidence of injury to it and were able to place it back inside his body.
Doctors discovered the wound had opened in the middle of the incision and closed it with multiple methods, including figure-of-8 sutures, one of the most advanced and strongest types of closures, internal and external stitches and stitches that penetrated multiple deep layers of the abdominal wall.
The patient’s skin was then closed with surgical staples.
Over the next several days, the man recovered without further complications and was observed to have a ‘reassuring abdominal examination.’
Doctors deemed him well enough to go home after one week.
The physicians said this case report was ‘important’ because abdominal evisceration after cystectomy is poorly documented, with just seven reports of the complication in 2024.