Gastroenterology Department of Huamei Hospital successfully rescued a patient with acute upper gastrointestinal hemorrhage.
- Date：2023-10-03
- Click：5877Times
Near noon on September 15, Director Yang suddenly received a call from Director Wang Zhenfeng of the Department of Integrated Surgery: a postoperative patient with cirrhosis of the liver and recent splenectomy suddenly vomited blood, the bleeding was extremely large, and the patient appeared to be hypotensive, so can we try to stop the bleeding under endoscopy. Time is life, director Yang Maowu immediately made a judgment after understanding the condition, the patient's esophagogastric fundal varices rupture possibility is high, considering that there is still persistent bleeding, need to immediately emergency endoscopic hemostasis treatment.
When the patient arrived at the endoscopy room, his blood pressure dropped to 76/50mmHg. The patient had been vomiting blood repeatedly in the past month, and he had undergone splenectomy within half a month, and the ascites due to cirrhosis caused the patient's abdominal distension to be like a drum, and the patient, who was already weak and frail, had a bleeding volume of more than 1,000 ml, and endoscopic resuscitation at this time was like rescuing a person from a fire with a high degree of risk.
The patient persistent vomiting blood, poor cooperation, director Yang one side of the communication with the patient as much as possible to make the patient cooperate with the gastroscopy, on the other hand, carefully operate the gastroscope, in the face of the field of view of the blood, director Yang rinsing side into the mirror, carefully wash the esophagus and the gastric body, the gastric sinus and other parts of the esophagus, did not find the bleeding foci, the patient's gastric fundus to deposit a large number of clots, which seriously affects the visual field of observation, unable to confirm the location of the bleeding, endoscopic suction, mesh basket Endoscopic suction, mesh basket hooking effect are not good, the patient's limbs are wet and cold, the consciousness is once blurred, signs of hemorrhagic shock, just when we are nervous and anxious, director Yang quickly issued a series of instructions: speed up the speed of rehydration, correct shock; contact the blood transfusion department, immediately prepare blood; put in the gastric tube to rinse the blood clots repeatedly and then apply negative pressure suction to remove the blood clots, and urgently look for the bleeding foci, the patient is only 40 years of age, we have to make the best effort!
Endoscopy nursing team immediately connected to the gastric lavage tube, and prepared a series of hemostatic facilities such as hemostatic forceps, hemostatic clamps, tissue adhesive, etc., Dr. Zhang Huashan led the anesthesia team on standby, ready for tracheal intubation for resuscitation, Du Fangjuan, deputy director, Dr. Li Zhihui coordinated with the rinsing of the gastric cavity, the field of vision is gradually clear, and finally in the fundus of the stomach to find a columnar jet bleeding foci, the blood as a fountain, and immediately given titanium clamps to stop bleeding, the spraying of blood! The bleeding stopped immediately, and all the people at the scene were relieved. In order to prevent secondary bleeding, the patient was given sclerosing agent, tissue adhesive and sclerosing agent in order to prevent secondary bleeding. After the bleeding stopped, the patient's blood pressure gradually rose, looking at the patient he “snatched” back from the death line, Director Yang breathed a sigh of relief.
The hemorrhage patient was finally rescued successfully, look at the time, it was already one o'clock in the afternoon, although we are full of fatigue, but feel immensely gratified!
Another bloody storm, another case of successful resuscitation, this gastrointestinal hemorrhage patient's rescue process can be called “do not give up, do not give up”, the patient is hovering on the edge of life and death, the doctor a little hesitation may kill the patient's life, like a marathon, do not allow a moment to stop until the patient turns to be safe. In front of the rescue of critical patients, the department and the medical and nursing close cooperation, interlocking, concerted efforts, reflecting both the high technical level, but also reflects the medical and nursing staff sincere cooperation, unity and hard work of the spirit of struggle.
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