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MatthewHJonesAuthor
06-18-2014, 08:09 AM
In the climax of my WIP, there's a three-way fight where my protagonist gets kicked, very hard, in the stomach. This causes internal bleeding. Antagonist A is a escaped prisoner (he does the kicking.) Antagonist B is a doctor who's been told to kill the protagonist.

Knowing that Antagonist B is an "evil doctor" is only important to this post for two reasons:

A.) The fight gets interrupted by the police, so she has to at least make it look like she's treating the guy who's vomiting up blood.

B.) The protagonist attempts to warn the police about the "evil doctor". However, he passes out. (I've assumed that blood flooding into the stomach would logically cause a light-headed feeling and nausea. I also assumed there'd be extreme pain.)

MY QUESTIONS:

1.) Are any of my assumptions wrong?

-1.a) is it possible to cause internal bleeding with a strong kick?

-1.b) would you vomit up blood if the fight was only minutes ago?

-1.c) could you pass out or would you be in too much pain?

-1.d) would you feel sick, or dizzy from this injury?

2.) Beyond feeling sick, dizzy or in pain, what else would my protagonist feel?

3.) Is this injury survivable?

Any help anyone could give is highly appreciated.

robjvargas
06-18-2014, 04:39 PM
I'm not sure it would be that immediate.

There's always a kick to the ribs, breaking one or more and causing a pneumothorax as well as possibly internal bleeding.

When I think of stomach injury as you describe, I think of the movie Grifters. In that movie, the protagonist attempts a "Short Count" con in a bar. When it fails, the barkeep jabs his gut with a baseball bat. It was several hours before the protagonist collapsed from the internal bleeding.

The stomach is basically a kind of tank. It has to fill up some amount, I suspect, before it reveals the distress going on.

Rufus Coppertop
06-18-2014, 11:23 PM
Your scenario doesn't seem plausible to me. To vomit blood, I imagine the stomach would have to be ruptured to the extent that gastric juice would be leaking into the abdominal cavity.

Mind you, I'm not a doctor or a trauma specialist.

sheadakota
06-19-2014, 12:00 AM
Vomiting blood is not a sign of internal bleeding as much as gastric ulcers. When you say getting kicked in the stomach are you suggesting the actual stomach or the mid- abdominal area, because getting kicked in the stomach is not going to go much of anything but hurt. The stomach is a really really tough muscular organ. Now blunt force trauma to say the spleen or liver will indeed cause bleeding but from a kick it will be slow and insidious and not cause vomiting of blood- usually that happens when there is a pulmonary hemorrhage. Tell me what you want to happen and I might be able to give you a plausible scenario.

asroc
06-19-2014, 12:03 AM
Gastrointestinal bleeds will often present with bloody vomit and they may cause hypovolemic shock, but in ten years of EMS I've never seen anything like this caused by blunt force trauma, including beatings, car accidents and explosions. It was pretty much always the result of a medical problem—stomach cancer, peptic ulcers, gastritis and so on. The stomach is quite flexible and pretty well protected.

That's assuming you actually mean the stomach as in the organ, and not the abdomen. Solid abdominal organs like the liver or the spleen are much more susceptible to blunt injuries than hollow organs. They're also more likely to cause significant hemorrhage. If you bleed enough you will eventually get light-headed, confused and finally lose consciousness. That means you're about to die, though. If the protagonist is supposed to live EMS better be there right away. (Evil or not, without equipment a doctor won't be able to do much for the patient.)

MatthewHJonesAuthor
06-19-2014, 02:44 AM
Thank you, everyone, for your expertise. Vomiting feels very striking and exciting (for a fictional character. It'd probably suck in real life.), but I wanted to inflict realistic injuries on my characters. So, vomiting blood is out.


Tell me what you want to happen and I might be able to give you a plausible scenario.

I need my MC to nearly die, and to lose consciousness, trying to warn the police of the "evil doc." After reading these comments, I'm thinking of just writing in a knife and stabbing the poor guy. Possibly, a punctured intestine or a liver might do the trick.

Do I sound as twisted to you as I do to myself?

maggi90w1
06-20-2014, 02:58 PM
Injuring a big artery might do the trick. He would pass out fast and die without help.

midazolam
06-22-2014, 08:42 PM
This article might be of interest to you.

http://onlinelibrary.wiley.com/doi/10.1197/S1069-6563%2803%2900359-2/pdf

The main point is that hematemesis (vomiting blood) in the setting of blunt abdominal trauma is rare, and there is usually some underlying pathology that connects the two, but it definitely has happened. So you wouldn't be completely off-base to write a scene incorporating this. In this particular case, the patient vomited a massive amount of blood after blunt trauma and would have died within a few hours if he hadn't been in a hospital.

Stabbing is a bit less exciting, but you could go that route, too.

sheadakota
06-22-2014, 11:31 PM
This article might be of interest to you.

http://onlinelibrary.wiley.com/doi/10.1197/S1069-6563%2803%2900359-2/pdf

The main point is that hematemesis (vomiting blood) in the setting of blunt abdominal trauma is rare, and there is usually some underlying pathology that connects the two, but it definitely has happened. So you wouldn't be completely off-base to write a scene incorporating this. In this particular case, the patient vomited a massive amount of blood after blunt trauma and would have died within a few hours if he hadn't been in a hospital.

Stabbing is a bit less exciting, but you could go that route, too.

according to this article though, the cause of the hemetemesis was alchohol related. The patient was an alcoholic with a sudocyst that rupture through his gastric wall- this was the cause of his vomiting the blood and was not brought about by the trauma rather by his compromised liver/spleen/bleeding times brought about by his disease- alcoholism. It seemed the trauma staff decided that the rupture would have occurred without the trauma and the accident probably saved his life. (at least that's what I got out if it :) )

MDSchafer
06-23-2014, 03:53 AM
If the guy you want to be vomiting was alcoholic and had esophageal varices, and the blunt force trauma jolted him enough to cause the varices to rupture then he would be vomiting blood