Operative notes:
A mid-line incision was made, and the abdomen was opened in layers. Muscular tears with traumatic hernia at the level of the umbilicus showed herniation of omentum and bowel, with active bleeding from the muscles. Haemoperitoneum was estimated to be about 1 litre. Exploration of the small bowel/mid jejunum revealed a 3 cm mesenteric tear with active bleeding. Ligation of the bleeder and repair of the mesenteric tear were performed. There was bleeding from the transverse colon mesentery, and ligation and repair were undertaken. A small splenic hematoma with no active bleeding was observed. The liver, stomach, and the rest of the large bowel were normal. The diaphragm was intact.