ACUTE ABDOMINAL PAIN

Alaska, Denali National Park, Mount McKinley, West Buttress

Alan Arnette (50) registered with the National Park Service as a client with an Alaska Mountaineering School guided expedition (AMS-11) on June 12. Following an uneventful climb to 17,200 feet, Arnette began experiencing difficulties acclimating to the altitude, so his guides decided to escort him back to the 14,200-foot camp to await the return of his expedition. During the descent, Leighan Falley, the AMS guide that was escorting him, radioed the ranger camp that at 1300, her client had experienced an acute onset of abdominal pain accompanied by nausea and vomiting. She declined any assistance at that time but did maintain radio contact throughout the day to keep the ranger staff apprised of their progress. Arnette arrived at the 14,200-foot camp at 2100 and was taken to the rangers for medical examination. He stated that he had experienced a sudden onset of sharp pain, rated 7 out of 10 on a pain scale, throughout the lower quadrants of his abdomen, and accompanied by nausea and vomiting. He had been taking NSAID’s and was given a suppository to help alleviate his nausea and vomiting. During his descent he also experienced a bowel movement at the top of the fixed lines at 16,200 feet. This movement was small but the description was indicative of Melina, which was in keeping with a lower gastrointestinal bleed or bowel obstruction. Dr. Jennifer Dow, the NPS physician sponsor, was consulted. She concurred with the probable assessment and recommended an immediate evacuation.

Analysis

Injuries and illnesses are to be expected during a mountaineering expedition and, regrettably, can occur regardless of planning. This was simply a case of bad luck, and it was fortunate that it occurred on descent in a location where his guide was able to assist the client down without much difficulty.

Had this event occurred above 18,200 feet, the evacuation would have been more difficult and hazardous. The patient’s guides handled the situation in an exemplary manner and should be commended for recognizing that their client was not doing well physically and taking steps to get him down to lower altitude without outside assistance. (Source: Edited from a report by John Loomis, Ranger)

(Editor’s Note: While this is not included as a climbing accident, the narrative is presented for its educational value. There was another abdominal incident that required a helicopter evacuation. In this case, it was suspected that the patient had developed a kidney stone.)