This article has been updated with new reports following medical consultation
A court hearing for Bojan Cmelik took place earlier today, and new findings have shown that Hugo Chetcuti lost two litres of blood before succumbing to the injuries inflicted on him back in July. In a report by the Times of Malta, several doctors took to the stand to give their evidence of the events surrounding the stabbing.
After emergency physicians noted severe internal bleeding on ultrasound, the hospital’s surgical team were alerted and Chetcuti was rushed to the operating theatres after attempts at maintaining his blood pressure failed. Mr Ayman Mostafa, the surgeon on-call the night of Chetcuti’s stabbing, explained that over two litres of blood were retrieved from the abdomen, and a total of four bowel perforations were closed. The bowels were reportedly checked for leaks three times over, however none became apparent at the time of suturing.
Mr Mostafa explained that following the surgery, Chetcuti was transferred to ITU where he was deemed stable. The case was handed over in the morning and it was not until three days later that Chetcuti’s condition began to deteriorate and he was operated once again.
Mr Alex Attard, the consultant surgeon caring for Hugo Chetcuti, also took to the stand. Mr Attard explained that on reopening the bowel, pus (evidence of infection) was discovered along the bowels. He also noted that the perforation sutured by Mr Mostafa in the first surgery was intact, however fluid had leaked into the abdominal cavity subsequently causing the infection. A foot of bowel was removed and the healthy intestines were sutured in the second operation.
Forensic doctors presented evidence that the leak in the second operation may have been present since the first operation. When questioned, Mr Mostafa explained the leak was only discovered 30 hours after the first operation, and may have very well been a micro-perforation which subsequently leaked as the tissue broke down. “It might have been a very late complication of the stab wound,” said Mr Mostafa.
Mr Attard echoed his sentiments, saying that a full penetration may have developed after the fact. The folds and non-linear structure of the intestine make it difficult to spot stab wounds, and a microscopic perforation may develop into a much larger leak in the long-term.
In addition, Mr Attard explained that the infection took it’s toll on Mr Chetcuti given his weakened state. The bacteria found was opportunistic, and carried a high mortality rate. “A normal person may fight this bacteria and get over it […] a patient who had lost three litres of blood is no longer a normal person.”