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Open AbdomenAccuracy 3.3/5

Megan Hunt: open abdomen, fistula, adhesions, hernia, and failed closure

Megan returns with an open abdomen, fistula, hernia, and adhesions; Meredith attempts tissue expansion and closure, but there is not enough tissue.

In Plain English

Megan's abdomen cannot simply be stitched closed because her organs, skin, fistula, hernia, and prior wounds create a complex reconstruction problem.

What Happened in the Episode

Meredith stops during closure when she sees there is not enough tissue to cover the abdominal defect.

Clinical Concept

Complex open-abdomen reconstruction with fistula and loss of domain.

What ER Teams Would Evaluate

A real team would map the fistula and abdomen, assess nutrition and infection risk, plan reconstruction stages, discuss stoma goals, and prepare backup options if closure fails.

Treatment and Management Overview

Episode-supported management includes fistulagram, Botox injection, saline tissue expansion, surgery, implant removal, and attempted closure.

What TV Gets Right

The episode recognizes that closure can fail even after an elaborate reconstructive plan.

What TV Compresses

The episode compresses nutritional optimization, staged reconstruction, fistula-output management, infection control, wound care, and consent around alternatives.

Sources and Further Reading