B.M.C. Rocks again!
Accha now that everyone has recovered from the operating in Sandas incident I have to tell you about what happened on Friday.
What was supposed to be a relatively normal major operation turned out to be a complete disaster. This guy was supposed to be operated for an intra abdominal cystic swelling most probably a dermoid and was prepared and kept waiting while we finished some of the easier one's before our lecturer and other miscellaneous bosses arrived.
My lecturer, lets call him Dr. Broadwalk came in in a frenzy and said come on come on lets take him on the table we have a lot to do.
So we did. My Asso Prof Dr. Lefty comes in too and we're ready to go.
We start the operation around 11 am and its evident almost immediately that we've bitten off more than we can chew!
The cyst ? tumour is present retroperitoneally ( which for my non medico ppl is in the back compartment of the abdomen....Yes there are two compartments ) and is in a position to cause much discomfort to all standing at the table.
Its arising out of the uncinate process of the Pancreas and has grown in such a way that it has stretched out the Duodenum and head of the pancreas laterally and the superior mesentric vessels medially.
Now the head of our unit (H.O.U) walks in Dr. Black and decides that the best approach is to go through the fibrous covering of the cyst and dissect it out de novo.
Well they tried. He was wrong wasn't he. The moment they tried getting into that plane the superior mesentric vein which was stretched to a great degree starts ripping of along with the layer.
As we all know BLOOD happened in a fairly large amount and the guy's blood pressure drops to 80 / palp. This my non medico friends is not a good thing!
Then in true hindi movie style there is a mad rush for blood transfusions and platelets and fresh frozen plasma anything that will get this previously hypertensive guy out from his current state of extreme hypotension. (excuse the pun)
Blood is pouring out of his vein and we're trying to clamp the vessel and ligate it. One prolene stitch taken and the tear extends just a little beyond where the stitch is. One more and the same thing happens and the vein just strips off. My second honorary surgeon Dr. Hey comes in looks at what is going on and very suspiciously leaves almost immediately saying there is an emergency at his private operating hospital. Uhhh Hello what do you think this is...A routine day care surgery!!!
Now just for those ppl who think this is a little toooo long to read this line was meant as a break.
Remember now, I work at Rajawadi bole to BMC hosp. So our great Murphy's law comes into full force at just the opportune moment and the cautery stops working (non medicos that is what we use to coagulate the vessel so it stops bleeding). Now there is a mad rush again in true bollywood style to get another cautery machine into to OT.
We would think that this was enough... Right, right WRONG.
BMC people ---- The damn suction machine (non medicos the thing that was sucking the blood out of the operative field so we could take the stitches) stops sucking! I mean it just stops cold turkey. No power failure, no clots, no warning alarm, nothing, it just stopped!
Now we're using mops like chindi's to see whats happening.
My H.O.U is now a bag of worms and does the wise thing of eating some humble pie and calling for help. The head of the department of surgery in my hospital is called in and I quote "I am in deep trouble here can you please come quick this is an emergency"
In walks Dr. Daredevil (the reason behind the name some other blog) and uses some quick saline dissection to expose fully the tear in the vein and to make a long story short saves the day.
The patient has lost some 5 litres of blood which by the way is the entire cardiac output. He is in the ICCU and is fighting for his life. We're monitoring him 4 hourly and hoping we can get him out of this one!
Moral of the story...None. Its the freaking BMC they never learn!
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