The biggest fear was hypoxic brain injury which happens due to lack of blood supply to brain when heart was stopped twice. But fortunately, no major injury to brain detected and he improved on medical management.
MUMBAI: A team headed by Dr Imran Shaikh, Consultant GI & HPB surgeon, Wockhardt Hospital, Mira Road, saved the life of a 56-year-old man with an infection and ruptured gall bladder that led to multi-organ failure. The patient was very critical with lifesaving supports for heart and lung, underwent major life saving surgery - Exploratory laparotomy with cholecystectomy and peritoneal lavage with drainage. The patient Prakash Acharya is now discharged resumed his routine.
Acharya, a resident Bhayandar, who is working as supervisor encountered excruciating abdominal pain and vomiting. The pain was so severe that he needed injections. He couldn’t eat food.
He was admitted to nearby nursing home and on evaluation found to have Gall bladder stone with severe infection and complication like a rupture. There was a severe infection along with multiorgan failure that took a toll on his kidneys, lungs, and heart. He was critical and planned Gall bladder surgery at a nursing home.
After anaesthesia he suffered cardiac arrest and was given Cardiopulmonary resuscitation (CPR), a life-saving technique to revive him. After two attempts of CPR, he was revived and surgery was deferred. He was put on ventilator and shifted for further management at Wockhardt Hospital, Mira Road.
Dr Imran Shaikh, explained: “The Patient arrived in a very bad shape. In emergency room he was unstable with on high ventilatory and cardiac support. We immediately shifted him to ICU on life saving support. His condition was so critical that despite maximum ventilatory support his oxygen saturation would remain around 88 %. He required three lifesaving drugs in very high dosages to barely maintain his heart and blood pressure. His kidney was hit badly with high creatinine and low urine output. An emergency CT scan of chest and abdomen done which showed worsening infection in abdomen as well as in chest.”
The Patient’s vigorous resuscitation continued in ICU as per standard protocol. Higher antibiotics, nutritional support, ventilatory and BP support and Kidney supports were continued. Most important decision was to operate upon him which was supra major surgery and considering critical status of patient it would have been very high risk to his life, Dr Shaikh said.
“We waited almost 24 hours and continued resuscitation before we could make him little better to subject for surgery. Team of doctors including intensivist, physician, chest physician, cardiologist and gastro-surgeon tried very hard to make him stable so that surgery can be performed,” he said.
The Surgery was lasted for four hours and luckily the patient tolerated the process very well. During surgery, lot of pus and infection drained from abdomen and Gall bladder was removed. The whole abdomen was thoroughly cleaned. He was shifted to ICU on all lifesaving support.
“As soon as surgery controlled the source of infection, he showed remarkable recovery in ICU. Within 72 hours his heart and BP stabilised and kidneys improved. Though he required ventilator for 5 days but made uneventful recovery. After 7 days of surgery he was shifted to wards on full diet. While recovering, he remains drowsy. In spite all other organs were improving, neurologist opinion was sought. The biggest fear was hypoxic brain injury which happens due to lack of blood supply to brain when heart was stopped twice. But fortunately, no major injury to brain detected and he improved on medical management. After two weeks from surgery he was all fit and discharged.
Dr Shaikh too heaved a sigh of relief and appreciated the teamwork of all doctors and staff at the hospital in critical management of Acharya’s complicated case.
The surgeon pointed out that many people tend to take gall bladder stone very lightly, and do not realise that it can lead to life-threatening complication like acute infection, Jaundice, perforation, gangrene and Cancer.
“We can avoid this complication by simple Laparoscopic surgery in elective setting which requires only one day’s hospital stay. Also, whenever any complication happens it should be managed at tertiary care center where all facilities and experts are available,” he said.
“My abdominal pain was unbearable to the extent that I couldn’t even move or walk properly. My world came crashing down after I got to know that the gallbladder has ruptured. I was hoping for some miracle to happen and was happy to know that the doctors gave me a fresh lease of life. I thank the doctors for their limitless efforts taken amid the pandemic. Now, I can do my daily chores with ease and have resumed to normal life,” said a happy Acharya.