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Shashikant Patel |
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| Case |
A 52 year old obese diabetic, hypertensive, hypothyroid male presented to Sterling Hospital with haemetemesis (vomiting of blood). He had a past history of atrial fibrillation. UGI Endoscopy revealed a large duodenal ulcer, which was injected and he was started on medical management. |
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He bled massively in the early morning 2 AM of 1st February, 2002 and collapsed in the ICU. He was immediately wheeled to the operation theatre and was operated by Dr. Sanjiv Haribhakti. He was found to have cirrhosis of liver. He was bleeding from a large duodenal ulcer, which was suture ligated and a truncal vagotomy and pyloroplasty was performed. Intraoperatively, he was persistenly hypotensive, inspite of control of bleed. A cardiologist was consulted and shashikantbhai was detected to have atrio-ventricular dissociation. He was treated with drugs and had to be cardioverted. He immediately recovered sinus rhythm and haemodynamically stabilized. Later in the ICU, he developed burst abdomen which was resutured. He developed a bilary fistula which healed on conservative management. He also developed multiple episodes of atrial fibrillation which required DC shock three times in the postoperative period. He also had renal dysfunction which was managed without dialysis. He had a prolonged stay in ICU on parenteral nutrition and finally after 3 weeks in ICU and 6 weeks in hospital, Shashikantbhai completely recovered. |
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On followup till march 2004, Shashikantbhai is in good health except for anemia related to cirrhosis of liver. |
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