My Friday night plans of studying with a film in the background after visiting the balloon festival vanished a few hours ago with a single phone call asking me to assist in an emergency surgery for a dog bleeding into the abdomen. 14 minutes later I arrived at the surgery to help prep the operating theatre and patient.
Now a bleeding abdomen is an emergency, as if untreated the animal can lose all its blood into the abdomen and die from blood loss (even though the blood is still insider the body). Generally this occurs from trauma, however there are circumstances where it occurs for other reasons such as the rupture of a tumour or complications after a surgery.
Generally our goal is to control the bleeding, and so anything we have that can tell us where the bleeding is coming from is good. Before I arrived the doctor had already done a ultrasound exam to confirm that there was indeed fluid in the abdomen, and was just finishing in x-ray, which is our case showed changes on the spleen so we were pretty certain this was where the bleeding was located.
Usually in a bleeding abdomen once you open it is a race against the clock to find and stop the bleeding. This is not easy when the entire abdomen is filled with blood and you cannot see much at all so have to rely on feel and knowledge of anatomy. In our case because we had localised it to the spleen this made surgery easier, as when you open the abdomen the spleen is one of the first things that you can see.
The blood vessels supplying the spleen were ligated (tied) and the spleen was removed from the body. The blood that had leaked into the abdomen was removed by suction and then we proceeded to flush the abdomen with sterile saline.
Sadly however there are only a couple of reasons for rupture of a tumour of the spleen, and here we still do not know which we are looking at. Proceeding to stabilise the patient post-surgery, we knew they were still alive because of us, and were given the best chance. However looking forward we do not know for how long as if the tumour is malignant then 2 month survival time is very low.