On January 14, Dr. Vo Hong Minh Cong, Deputy Director of Gia Dinh Other people’s Sanatorium in Ho Chi Minh Town, stated that there had simply been a perfect surgical treatment to avoid wasting a affected person with a particularly uncommon illness, the entire global had simply carried out it. There used to be 1 reported case.
The affected person is Mr. QPT (38 years previous, dwelling in Ca Mau province) hospitalized in important situation because of acute blood loss. In line with clinical historical past, in 2021, the affected person used to be identified with portal vein obstruction (the vein machine that drains blood from the intestines to the liver) because of thrombosis and used to be handled with anticoagulants for six months.
On the finish of 2024, whilst operating in Ho Chi Minh Town, the affected person all at once had critical stomach ache across the navel, had a considerable amount of purple blood in his bowel actions, and fell into acute hemorrhagic surprise. The affected person used to be taken to the emergency room at Gia Dinh Other people’s Sanatorium by way of his circle of relatives. Docs instantly resuscitated the affected person for hemorrhagic surprise and carried out imaging diagnose the reason for gastrointestinal bleeding.
Exam pictures record the very complicated clinical situation the affected person faces
Result of computed tomography (CT-scan) of the stomach printed power portal vein obstruction, cavernous sinus transformation (massive dilated restructuring of the vascular machine because of power obstruction) within the hilar area of the liver, the primary purpose. The reason for bleeding is malformation and diffuse intestinal arteriovenous anastomosis, inflicting dilation of mesenteric vein branches. As well as, the affected person additionally suffered from power portal vein thrombosis.
Regardless of clinical remedy mixed with gastrointestinal endoscopy to forestall the bleeding, the gastrointestinal bleeding nonetheless recurred, leaving the affected person in important situation. The clinic has mobilized interdisciplinary session to seek out the purpose and optimum remedy answers for the affected person.
Diagnosing and discovering remedy answers for the illness face many difficulties. In line with analysis within the clinical literature, docs found out that there has handiest been one reported case in america with equivalent signs. Right away after figuring out that this used to be an overly uncommon case, the clinic board of administrators licensed the pro council and made up our minds that the surgical plan required complete coordination between surgical and inside intervention consultants. circuit. The laparotomy mixed with intraoperative endovascular intervention used to be carried out regularly by way of 4 surgical groups, lasting from 8 a.m. to eight p.m.
Physician-CK2 Vu Ngoc Son, Deputy Division of Gastrointestinal Surgical procedure, Gia Dinh Other people’s Sanatorium, stated that sufferers with acute blood loss needed to be regularly transfused all the way through surgical treatment. The overall quantity of blood transfused to the affected person used to be upper than the volume of blood given to the affected person. blood within the affected person’s frame. This has brought about a blood clotting dysfunction that makes surgical treatment very tricky.
After surgical treatment, the affected person’s well being recovered neatly
“After greater than 30 years of operating within the clinical box, this can be a uncommon illness and really tricky for us to regard. The surgical treatment lasted greater than 12 hours. All through the surgical treatment, the docs uncovered the site of the vascular malformation, approached the clogged vein, and created a bridge from the portal venous machine to the vena cava to scale back Most force of the portal venous machine. Just about 3 meters of small gut containing vascular malformations needed to be got rid of to make sure keep an eye on of recurrent bleeding after surgical treatment and the remainder phase used to be reattached to revive intestinal stream” – Dr. Ngoc Son stated.
After primary surgical treatment, the affected person used to be intently monitored and handled. His well being recovered neatly, his digestive serve as used to be nearly commonplace, he now not had gastrointestinal bleeding, and he used to be handled with solid anticoagulants. That is a particularly uncommon case, intervention used to be very tricky, however docs stored my lifestyles.