Dubai: Santosh, an engineer, working in the UAE had been suffering from severe abdominal pain for over six weeks.
The severe abdominal pain lasted 42 days.
How the team of specialists helped identify a cascade of severe attacks with complications, and how the patient recovered borders on the miraculous.
Initially, Santhosh, a 44-year-old Indian national, was treated for severe acute pancreatitis (infection of the pancreas) by specialist gastroenterologist Dr. Shareej at Zulekha Hospital Dubai.
A few days later, the pain recurred — this time with fever, nausea and vomiting.
Further investigations were carried out.
A CT scan revealed an infected walled off necrosis (dead tissue due to lack of blood supply) due to the acute pancreatitis with left-sided pleural effusion (abnormal collection of fluid between the thin layers of tissue lining the lung and the wall of the chest cavity).
The cyst measured 14.6x 10.2 x 8.6 cm.
He also developed symptoms that indicated sepsis (generalised infection), which could lead to life-threatening complications, if left untreated.
Dr. Fathelrahman Mohammed, General Surgery Consultant at the hospital advised him to undergo a minimally-invasive drainage of the collection under ultrasound guidance with assistance from Dr. Anurag Ayachit, Radiology Specialist.
Emergency
The infection continued to progress. The emergency situation now required a multidisciplinary team of clinicians including general surgeons, gastroenterologists, radiologists, intensivists, anaesthetists, a clinical dietician and nursing staff to help save him.
Without wasting time, a set of minimally-invasive surgeries was carried out by Dr. Fathelrahman along with Dr. Saajan Ignatius Pius, Specialist General Surgeon, and Dr Ajay Patekar, Consultant Anaesthesiologist using advanced medical techniques.
Santosh had to undergo several procedures.
One was a laparoscopic cystogastrostomy (surgery performed to drain a pancreatic pseudocyst that develops after acute or chronic pancreatitis).
Another was a laparoscopic pancreatic necrosectomy (endoscopic drainage and debridement of pancreatic necrosis), followed by laparoscopic drainage of collection (abscesses); and intercostal tube insertion for pleural effusion.
The procedures helped drain the fluid collection directly into the stomach to avoid fistula (abnormal connection between two body parts). The necrotic tissue was removed and then the encysted pus (accumulation of dead material) collection was drained.
For pleural effusion drainage, the chest tube helped remove the fluid collection in the chest for investigation, which helped relieve the lung collapse.
High lipids: severe attacks of complication
Dr. Fathelrahman said: “The acute pancreatitis may have happened due to presence of high lipids in the blood. People should be watchful as acute pancreatitis can happen as a result of high lipids.
“Avoiding alcohol, fatty meals and checking for gall stones can be helpful. In situations such as these where the individual develops severe attacks with complication, they must choose the right hospital with multidisciplinary care for treatment.”
Acknowledging the life-saving care at the hospital, Santosh said: “Their expertise and careful efforts in the intensive care unit led to the successful removal of the necrotic dead tissue and my life has been saved. I am extremely thankful to all the doctors and nursing staff at the hospital.”
Santosh recovered within nine days and was discharged with advice on managing his health better.
