Industrial Worker Requires Gastrointestinal Surgery Following On-Site Accident

This case involves a 43-year-old female industrial worker who was involved in an on-site accident. She was admitted to the hospital with severe abdominal trauma, broken sternum, and head trauma. On her third day in the hospital, it was determined that she had an obstruction of the small bowel. The patient subsequently required resection of about 40 cm of her small bowel. Following her surgery, the patient continued to suffer from a range of gastrointestinal complications. An expert gastroenterologist was sought to review the patient’s medical records and determine the extent of the injury and how it may impact the patient in years to come.

Question(s) For Expert Witness

1. Please explain why you're qualified to serve as an expert witness on this engagement.

2. Are you able to determine the long-term consequences of having a large section of small intestine removed?

Expert Witness Response E-020842

I am a board certified gastroenterologist and internist, and I have completed an additional fellowship in clinical nutrition and small bowel disorders. I see patients who have a variety of small bowel problems, including prior small bowel resections. There are a variety of gastrointestinal and nutritional problems that patients are at risk for when small bowel is resected. The types of problems depend on a number of factors: the location of bowel removed, the length removed, the type of surgery performed, how the anastomosis was created (and if there was an ostomy involved), surrounding medical circumstances (ischemia, infection, etc), prior medical problems, medication use, etc. Follow-up care is also important to ensure both adequate surgical healing as well as medical therapy for whatever gastrointestinal and nutrition-related problems occur. With a thorough review of the medical records, I would be able to opine on the long-term consequences of this patient's small bowel resection post trauma.