Deceased
Celia Laurel Ivy Sands
Demographics
82y, female
Date of death
1999-05-15
Finding date
2001-09-07
Cause of death
peritonitis due to a perforated viscus (proximal jejunum) resulting from motor vehicle accident
AI-generated summary
An 82-year-old woman suffered a motor vehicle accident causing blunt abdominal trauma. Despite initial clinical assessment appearing adequate, a perforated jejunum with developing peritonitis was not diagnosed until early morning of day 2, when she had deteriorated significantly. Key clinical lessons: (1) In blunt abdominal trauma, CT scanning should be considered early even with initially reassuring signs, particularly in elderly patients who may be stoic about symptoms; (2) Objective deterioration—decreased urine output, persistent pain beyond 24 hours, fever—should trigger escalation and senior review; (3) Critical vital sign changes including acidosis, hypoxia, and tachycardia in the early morning of day 2 indicated sepsis/peritonitis requiring immediate surgical consultation. The senior surgeon should have been notified when these objective findings emerged, though prognosis remained grave given established peritonitis and her age.
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Specialties
Error types
Clinical conditions
Procedures
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