Rare Case of Persistent Bleeding in Jewellery Worker Successfully Treated by Emergency Surgery
26th June 2024, Kolkata – A rare and challenging medical case involving a 25-year-old impoverished jewellery worker from rural Bengal has been successfully treated by a team of specialists after he presented with severe and persistent blood vomiting.
The young man first went to another hospital, but an endoscopy and colonoscopy couldn’t find the source of his bleeding. Despite blood transfusions, his condition worsened, leading to his transfer to a specialized team.
Upon thorough evaluation, the medical team discovered a gallbladder stone and a blockage of the bile duct. During an endoscopic retrograde cholangiopancreatography (ERCP), it was observed that blood was emerging from the common bile duct opening. Further investigation through a tri-phasic CT scan of the upper abdomen revealed a massive 6 cm x 6 cm x 6 cm pseudoaneurysm arising from the right hepatic artery. This pseudoaneurysm, a swelling of the blood vessel supplying blood to the liver, was identified as the source of the bleeding into the common bile duct.
Dr. Sanjoy Mandal, who led the medical team, explained the severity of the situation: “The patient’s condition was critical, and immediate intervention was necessary. We counseled the patient on the need for angiography and embolisation, followed by surgery. Unfortunately, before we could proceed with the planned intervention, the patient experienced a massive bleed, necessitating emergency surgery.”
During the emergency surgery, the pseudoaneurysm was successfully ligated, and the gallbladder stone was removed. This comprehensive approach allowed the medical team to address the life-threatening conditions in a single procedure, thus preventing the need for multiple interventions.
Dr. Mandal expressed his relief and satisfaction with the outcome: “This case underscores the importance of rapid diagnosis and intervention in life-threatening conditions. The team’s ability to perform the necessary procedures in one surgical session not only saved the patient’s life but also minimized the risks associated with multiple surgeries. We are grateful for the successful outcome and hopeful for the patient’s full recovery.”
The patient is currently recovering well and is expected to make a full recovery. This case highlights the critical role of advanced diagnostic and surgical techniques in managing complex conditions.
Dr. Sanjoy Mandal,
MBBS, MS, DNB, MRCS, MCh.
Consultant GI surgeon
Laparoscopy & Oncosurgery
AMRI Hospitals
