'Offside flag would have prevented Awoniyi injury'

The injury suffered by Nottingham Forest striker Taiwo Awoniyi "would never have happened" had the assistant referee raised their flag earlier, says team-mate Ola Aina.

Awoniyi, 27, was woken from an induced coma on Wednesday after surgery to repair a serious abdominal injury.

The Nigerian was taken to hospital on Monday, having collided with a post while attempting to get on the end of a cross from winger Anthony Elanga in the closing stages of Sunday's 2-2 Premier League draw against Leicester City on Sunday.

Elanga was offside in the build-up to the incident but the assistant referee did not raise their flag until the play was completed because of an offside protocol introduced in 2020.

"Anthony was miles offside. The whole world could see and so could I from where I was," defender Aina told the Mail., external

"You think 'offside' straight away. Surely you could just lift the flag up?

"None of this would have happened to 'T' if the flag had just gone up, would it?"

BBC Sport understands Awoniyi sustained a ruptured intestine.

Having had the first part of the surgery on Monday, he spent Tuesday in an induced coma as medical staff monitored his progress.

Awoniyi had the second stage of the operation, including closing the wound, on Wednesday. He was woken from the induced coma in the early evening.

"It's horrible seeing someone you are close with go through something like this, but I pray to God everything goes to plan and goes well and that we will be hearing from him soon," Aina said.

Awoniyi received lengthy medical attention on the pitch after the collision and appeared to inform medics that he could continue.

It soon became clear that he was still feeling the effects of the collision, but manager Nuno Espirito Santo had used all his substitutes.

Forest owner Evangelos Marinakis came on to the pitch after the game to express his concern to Nuno over how Awoniyi's injury was handled.

Forest are set to open an internal review into the episode and establish why Awoniyi was allowed to continue playing.

A statement released by Forest on Tuesday referred to a "shared frustration between all of us that the medical team should never have allowed the player to continue".

The incident has raised questions about the offside law.

A new protocol on offsides was introduced by the International Football Association Board (IFAB) for the 2020-21 Premier League season following the introduction of the video assistant referee (VAR).

While the law did not change, assistant referees were told to keep their flag down if they felt there was an immediate scoring opportunity.

Consultant colorectal surgeon Prof Gillian Tierney told BBC Sport: "The injury is really serious. It is potentially life-threatening.

"It is very easy to miss at the point of contact and can take hours to diagnose.

"In a hospital setting we would send a patient for a CT scan which could take up to 10 hours.

"If it occurred to an athlete who was super fit, very muscular and was running on adrenaline then I think it would be extremely understandable to miss it. Fluid leaking from the intestine would not be easy to diagnose straight away.

"Surgery is usually required and the stomach would be opened up. The mortality stat is 9%. So if an athlete who went through the procedure was really fit, they would stand a good chance of being OK."

Harpaul Flora, consultant vascular and general surgeon at the London Clinic, said ruptured intestines are "a pretty rare injury".

He added: "It's either a compression of the abdominal wall which has led to tearing and liquid seeping out - or the tear of an artery.

"Neither of those would be able to be diagnosed without a scan. There may have been bruising.

"It can be life-threatening. If it wasn't treated by a hospital it can give you an infection. It could then lead to sepsis, which is a life-threatening consequence."