Integrated psychiatric and surgical care in managing self-inflicted abdominal trauma: a case report in a resource-limited setting.

Abstract

Introduction and importance: Self-inflicted abdominal stab wounds present rare yet critical challenges requiring urgent surgical intervention and comprehensive psychiatric evaluation. Such injuries often correlate with psychiatric disorders like schizophrenia and alcohol dependence, posing significant clinical and psychological management hurdles.

Case presentation: A 36-year-old male with a history of chronic alcohol use and schizophrenia presented with a self-inflicted stab wound to the abdomen following auditory hallucinations. Upon admission, he was hemodynamically unstable, with eviscerated bowel loops and a lacerated greater omentum. Prompt surgical exploration revealed extensive abdominal trauma necessitating meticulous repair and intensive postoperative care.

Clinical discussion: The case highlights the intricate interplay between severe psychiatric illness and self-harm, exacerbated by alcohol intoxication. Integrated psychiatric and surgical care proved pivotal in achieving stabilization and facilitating recovery. The challenges encountered in a resource-limited setting included a lack of advanced imaging modalities, limited access to specialized psychiatric care, and constraints in postoperative monitoring equipment, underscoring the importance of adaptive management strategies.

Conclusion: This report emphasizes the critical need for a multidisciplinary approach in managing self-inflicted abdominal injuries. The successful outcome underscores the efficacy of timely surgical intervention and comprehensive psychiatric support. Integrated care models are essential for addressing the complex needs of patients with psychiatric comorbidities, ensuring holistic management, and reducing the risk of recurrence in similar cases.