Wow. Not being a doctor, I have no idea. So I outsourced this question to my friend and invaluable critique partner, former Vietnam nurse Sharon Wildwind, author of Some Welcome Home and First Murder in Advent, and Poe’s Deadly Daughters blogger. Sharon wrote:
You can't do surgery on a serious abdominal wound by just taking the bullet out. There have been so many advances, that what I describe below might go quicker and easier in a major trauma center, but if there was no hospital available and the surgeon was having to do it "the old-fashioned way," I've outlined what he would have to do. The abdomen is crammed full of really useful things like liver, kidneys, intestines, etc, so it's almost impossible to have a serious abdominal wound without lots of things being damaged. Unfortunately those same things tend to bleed a lot. Sorry, but this is going to involve some yucky details
Step 1: open up the abdominal cavity wide enough to get both hands in. Hold it open with retractors.
Step 3: sluice out the abdominal cavity with sterile water and suction and look for any smaller spots that might be bleeding.
Step 4: maybe get an x-ray to see more than you can with the eyes or feel with your hands. Laproscopy (tube with a camera on the end) might also be used to locate bleeders.
Step 5: work one area at a time repairing every tear. Livers and spleens don't repair easily, though now I believe there are glues that are being used on livers. If the spleen has been damaged, remove it. Also, as long as you're in there, remove the appendix because once someone has had major abdominal surgery, they will have scar tissue and you don't want to have to go in through that scar tissue at a later time just to take the appendix out if appendicitis develops.
Step 6: spend a lot of time on the intestines because even a small hole that isn't repaired can cause bowel contents to leak into the abdomen and produced peritonitis. If the intestines have been damaged in multiple places, do a temporary colostomy so that fecal matter will be drained out before it passes over the healing areas.
Step 7: oh, yeah, take the bullet out.
Step 8: sew everything up in neat layers, inserting tubes and drains as you go.
Serious abdominal surgery can take 4 to 12 hours. Step 8 alone can take an hour or more.
That’s all she wrote, and it sounds pretty serious. As for how long he’d be out, I’m sure that all depends on how much morphine the doctor gave him. How long it took to resume normal activities like walking and driving would depend entirely on where he was hit.
Lisa Black is a full time latent print examiner/CSI and the NYT bestselling author of the Theresa MacLean series, including Takeover, Evidence of Murder and the recently released Trail of Blood. Please visit her website at http://www.lisa-black.com/.