New Delhi, February 10, 2020: In a rare turn of events, 19 year old Mukul, was rushed to the emergency department of Indraprastha Apollo Hospitals as he was stabbed over right area of the chest leading to fatal injuries and loss of blood.
Mukul was stabbed with the iron rod in his chest, when he got into a fight which resulted in puncture of the posterior chest wall. Excessive mediastinal bleeding is a significant complication of cardiac operations with cardiopulmonary bypass (CPB). It increases the risks of cardiac failure, dysrhythmias, and infection. Initial CT showed there was massive blood in the chest on the right side. The iron was seen close to descending aorta (major blood vessel from heart). He was immediately admitted to cardiac ICU. He was prepared for emergency surgery. A unit of blood was arranged. The heart lung machine was also kept ready for the procedure.
Dr Priyadarshini Singh, Head of Department – Emergency – Indraprastha Apollo Hospitals said, “What is crucial in such cases is following the ‘Golden Hour’ or the ‘Platinum Ten Minutes’. The emergency team rushed to attend the patient with immediate attention within five minutes of the patient being admitted to the emergency department, our primary mission is to give our patients the appropriate level of medical care in the fastest, most efficient manner possible.”
“The major challenge was that all the measures had to be done with him lying on his stomach (prone position) as he had this huge iron rod sticking out of his back. In such cases, the foreign body should not be touched till the patient goes to the operation theatre. This is because the object is actually helping to control the bleeding as it creates the pressure. If it is removed, then there can be chances of potential blood loss and death in minutes,” added Dr Singh.
Explaining about the surgical procedure, Dr Muthu Jothi, Senior Consultant, Paediatric Cardio Thoracic Surgeon, Indraprastha Apollo Hospitals said, “After proper evaluation we decided to perform thoracotomy which is a surgery to open the with the iron rod in position a thoracotomy was performed in front and back of the dagger. The chest was entered through 7th intercostal; space on entry there was injury to describing aorta. There was a big clot on the aorta. This was opened clot evacuated and a small tear in the aorta was repaired. There was additional injury to small area of left corner lope of lung. This was also carefully sutured. During this practice, an incision is made in the chest wall between the ribs to operate on lungs. An incision was made between 2 ribs, from front to back. We then placed a chest tube to make sure that blood or air does not collect in the chest.
Later he was extubated and put on nasal prongs with oxygen. There was also a linear tear on the L dome of diaphragm. This was repaired. There was 800cc of blood in R chest A R ICD was inserted to drain the blood. Finally, all bleeding points were sealed chest irrigated betadine saline and chest closed in layers. Mukul improved gradually and with the support of medication, he was discharged on the 3rd post-operative day.”
Father of Mukul said, “Mukul received immediate attention where he was examined and operated under the care of Dr Priyadarshini Singh and Dr Muthu Jothi. When we were told that the operation is successful, we had no words to express our gratitude to the doctor and his team. Indraprastha Apollo Hospitals has given my son a new lease of life for which we will forever be grateful.”
Such surgeries are complicated, highly demanding and need multidisciplinary team effort. They need clinical expertise and well-equipped operation theatres with advanced equipments. The treatment is usually prolonged and done in multiple stages. Successful execution of complex and risky surgeries demonstrate expert clinical services and advanced healthcare facilities available at Indraprastha Apollo Hospital. Domestic as well as International patients who would have otherwise gone to the United States of America or Europe for treatment are now choosing Indian Hospitals for affordable treatment, due to faith in doctors and excellent hospital care.