Intestinal Repair Helps Trauma Patient Go Home

Surgeons at WVU Medicine have helped a man get back to his life and family after a motor vehicle accident.

The patient was traveling with others in Maryland when he was in a severe accident that left him with a traumatic brain injury and internal injuries to the abdomen. He was airlifted to WVU Medicine J.W. Ruby Memorial Hospital for treatment.

“When he arrived here, he had multiple life-threatening injuries and was in profound shock (from the blood loss),” Alison Wilson, MD, FACS, WVU Medicine Critical Care and Trauma Institute Trauma, Emergency Surgery, and Critical Care division chief, said. “Our priority was to stop the bleeding in his abdomen and get him to the OR to manage his head injury.”

His intestines were separated from the abdominal trauma, and over a series of surgeries, his surgeons were able to reattach them.

Because he had been in such profound shock, Dr. Wilson said, he had an increased likelihood of complications, such as infection and poor healing.

“That degree of injury depletes the body’s nutrition and immune system,” Dr. Wilson said. "When that happens, we can control the infections and leakage by letting the wound come to the surface and remain open to prevent drainage into the abdomen. At that point, it is best to let the patient’s body recover and heal before performing more procedures.”

According to Dr. Wilson, it is common for patients to need to wait eight months to a year for the scar tissue from injuries and surgery to soften so that surgeons could perform a complete repair without causing additional damage. During that time, the abdomen is left open, and the patient receives total parenteral nutrition intravenously because consuming food can cause additional intestinal leakage, creating a higher risk of further infection.

When Guilherme Costa, MD, WVU Cancer Institute surgical oncologist, joined WVU Medicine in September 2023, he learned of the patient’s case and coordinated with his doctors to perform the surgical repair of the intestine.

Drawing on the techniques he learned as a transplant surgeon, Dr. Costa closed the open portion of the patient’s intestine, allowing the abdomen to be closed and the patient to begin reintroducing foods.

“The trauma surgeons did exactly what they needed to do to increase his chances of survival,” Dr. Costa said. “The priority was the head injury, ensuring he would survive long enough to have a chance at recovery. Once that was resolved and the patient was ready, we were able to close his intestine and abdomen, restoring his ability not only to eat, but to heal effectively.”

After a month of recovery, including physical therapy and the slow reintroduction of foods, the patient was able to be discharged to continue recovering at home with his family and young daughter.

“I’m very grateful to the nurses and doctors here,” the patient said. “They’ve treated me like family and made sure I have everything I need to go home.”