Mohali, February 17

 

Dr. H K Bali, former PGIMER, Intervention Cardiologist, Director of Cardiology Fortis hospital Mohali performed a rare surgery, saving the life of a 64-years-old patient who suffered from heavy internal bleeding in the abdomen due to rupture of the artery.

 

Flanked by the patient Dr. Bali said that patient Napinder Singh from Jalandhar was rushed in with rupture artery of the abdomen.

 

What had happened to the patient?

 

“The coeliac (the artery that supplies blood to liver, spleen, and stomach) artery and its branches were massively widened and had got ruptured. This had led to massive bleeding in abdomen and liver,” he said.

 

Patient Napinder Singh was at a high risk of further sudden massive bleeding, which could have proved fatal, without timely surgical intervention. The widening (an aneurysm) in artery was wide and more than four times its normal size. 

 

 

Why was the case rare?

 

“Large aneurysms of such artery are rare but important causes of intraabdominal vascular masses. Rarely they can rupture and cause massive intraabdominal bleeding. Napinder’s case was one of the rare cases,” Dr. Bali said.

 

Dr. Bali elaborated that such big aneurysms of this artery have very rarely been described in world medical literature. “It was a difficult surgery fixing such a wide gap and could have led to massive damage to the liver,” Dr. Bali said.

 

He added that patient Napinder had one of the largest aneurysms described in world literature measuring almost 20 mm in its widest part.

 

The widening was spread over an entire length of coeliac and hepatic artery. It had ruptured spontaneously causing major intraabdominal bleeding. A patient had lost a lot of blood, which spread not only around the widening (an aneurysm) but also seeped into liver wherein blood had collected into the tissue.

 

“This further complicated the surgery.  This is the first case in world literature of endovascular treatment of the ruptured giant aneurysm,” he added.

 

How the ruptured aneurysm treated?

 

Dr. Bali and his team treated this ruptured giant aneurysm of without major surgery over a period of three hours under local anesthesia. “We reconstructed the ruptured giant aneurysm. For this, we used two large stent grafts respectively. Such a procedure to treat giant ruptured aneurysm of the hepatic artery has never been carried out in the world earlier,” Dr. Bali said.

 

The patient:

 

Napinder Singh is symptom-free and was discharged from the hospital after three days of surgery. Dr. Bali informed that by endovascular technique it is possible to treat large aneurysm of different arteries of body and repair them. This technique prevents rupture and at the same time does not disrupt the blood supply to important organs.

 

Ruptured aneurysms are a very important cause of sudden massive intraabdominal bleeding. This can be fatal if not properly diagnosed and treated in time.