Stab Wound

Memnon624

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Hi all,

Here's what I have: a man in reasonably decent health (for the 12th century) is stabbed in the abdomen, slightly above the navel, by a knife with about a 9" blade. The knife goes in up to the hilt, is jerked upward, and is withdrawn. I understand that's a fairly nasty wound, possibly mortal. The man falls and curls into a fetal position and is left alone.

Here's what I need: after about a half-an-hour of unconsciousness, would the man be in any shape to get to his feet, after a fashion (lots of staggering), and make his way roughly the distance from, say, the southern edge of Central Park to Times Square? In fact, I need him to live for about 12 more hours before expiring -- and during the 12 hours he's bed-ridden, being looked after but not getting the finest medical attention, either. Does it sound believable? What are some of the physical "symptoms" (for lack of a better word) associated with a stab wound to the belly and slow bleed-out? Lots of pain? Smell of blood mixed with bowel from the wound? Loss of use in his limbs? What?

Thanks much for any help!

Scott
 

tallus83

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There would be no walking.

He would be dead, or bleed to death quickly. Even if he did survive, he would die from peritonitis. No anti-biotics to fight the intestines contaminating the wound.
 

ColoradoGuy

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I think your scenario is unlikely but not impossible. There is great variability in these kinds of things and I'd say do what your plot requires. I've cared for patients (healthy adolescents) who were stabbed in the abdomen and had surprisingly little pain. Peritonitis from injury to the intestines would ultimately kill him, but that could take several days or even longer. You would need to have the stab avoid major blood vessels, which is perfectly possible, although having the attacker twist and thrust the blade around a bit makes significant bleeding more likely. If you want him to die quickly after he's staggered around doing whatever you need for him to do, you could have a sudden bursting of a large vessel, which would kill him in minutes. It wouldn't be too far-fetched for his initial wound to have injured a big vessel, then clotted off for a while, then have the clot break off and kill him. So again, I say do what your plot needs and no reader will complain too much, even a trauma surgeon.
 

HeronW

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Running parallel to the spine is the descending aorta about as thick around as your thumb. If the blade hits that your char is dead in 5-10 seconds from sudden bleed out. Aneurisms form here as well, expanding the blood vessel walls to the size of a large grapefruit until they burst. Dragging a knife up would cut through the stomach, possibly the pancreas and spleen and up to the liver.
 

Memnon624

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Thanks for the replies!

Would it be "better", then, to have the knife enter below the navel? Is there a "preferred path" for the knife to take in order to bypass all the more important squishy parts?


Scott
 

tallus83

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Please remember the area you are talking about is the traditional hari-kiri spot for commiting suicide.

How about a smaller blade? Nine inches is a bayonet and will cause considerable damage if jerked upward. The victim, if he could walk, would be holding in his intestines. His lower abdominal muscles would all be severed, so there's a good chance he would not even be able to get up off the ground.
 

GeorgeK

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The entry wound in the middle does not mean the blade was straight in. Actually, hand held weapon wounds rarely are. If the blade is angled to the patient's left, a splenic injury could easily act like this and if to the right, a liver laceration. Within a few hours he would start to have rapid breathing and a rapid heart rate, trying to compensate for the decreased blood volume and therefore decreased oxygen carrying capacity. As a retired surgeon, this scene sounds like one of the more plausible one's that I've seen and is par for the course for internal bleeding prior to the advent of abdominal trauma surgery.
 
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GeorgeK

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Please remember the area you are talking about is the traditional hari-kiri spot for commiting suicide.

How about a smaller blade? Nine inches is a bayonet and will cause considerable damage if jerked upward. The victim, if he could walk, would be holding in his intestines. His lower abdominal muscles would all be severed, so there's a good chance he would not even be able to get up off the ground.

Nine inches is a common length for daggers and is shorter than my pig sticker which is 12 inches. The bayonet for my zouave musket is 18 inches. Also the intestines don't "fall out" in a stab wound. They are attached to the body, not free floating. People hold wounds as a reflex since compression helps with bleeding and pain, not to keep organs from falling out. It takes considerable effort to take organs out. It's not like popping a zit. You would need a much larger or longer violation of the abdominal wall to even see the intestines. Even if by some bizarre quirck, both rectus muscles were transected, the patient would most likely be able to get up and walk, not do crunches, but walking is feasible, not unlikely.
 

tallus83

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In the original question, the blade is inserted to the hilt then jerked upward. Which sounds a lot like the blade rips the skin, etc. and is not a clean stab in and removal. I am aware that internal organs don't just fall out.

I was thinking more of a WW2 bayonet which, except for the Japanese, was shorter than a Civil War type.
 

GeorgeK

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Normally the "jerking upward" refers more to the tip of the knife with the skin acting much like a fulcrum, such that the entry wound still mimics a simple "poke and pull". That's what has to be determined when you clean and examine a knife wound. Two identical looking skin wounds cn have very different internal damage. The organs are much easier to injure than the skin even though we humans have among the most frail of skins comparatively speaking. A 9 inch blade in the 1200's was much heavier and far more dull than a scalpel and would require a lot of strength, time, multiple attacks or luck to produce a deep wound (violating the internal organs) that also made a large jagged cut on the outside. Blades were made to either stab or slice. For the blade to be heavy enough to not break when the motion of attack is changed in the middle it would be very difficult to make it sharp enough to produce an "L" shaped skin wound. The 6 inch WW2 bayonets were made with a very different steel and still were designed to "poke and pull".

I guess it would also depend on training. A soldier or an assassin could conceivably perform things very differently than Joe the baker and have a specialized weapon that the average Joe didn't have. I guess my main point is that it is very concevable and even likely that someone in medieval to preindustrial times can have a delayed death from a stab wound. Immediate death is not the norm, but for a good assassin it should be.
 
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