The patient was admitted to the hospital with generalized peritonitis due to a perforated gastric and duodenal ulcer and was brought to the emergency room late for a series of other underlying diseases such as cardiovascular, respiratory, bone and joint diseases, disc herniation... leading to life-threatening conditions. However, the patient was lucky to escape death thanks to the successful emergency surgery performed by doctors from the Department of Digestive Surgery, E Hospital.
Through the medical history, the patient suffered from chronic lumbar spine pain and had bought medicine for self-treatment, but the medicine contained painkillers that had side effects on the stomach and duodenum and caused perforated ulcers. Furthermore, because the patient was old and weak with many underlying diseases such as blood pressure, cardiovascular disease, etc., the symptoms of perforated stomach and duodenum lasted for 4 days. The patient continued to use painkillers but the condition did not improve, and even became more severe.
When severe septic shock and abdominal distension appeared, the patient was taken to the hospital. Doctors urgently examined and performed the necessary paraclinical tests. The abdominal CT scan results showed: Peritonitis due to perforation of the hollow organ in the anterior part of the duodenum - antrum. Recognizing that this was a dangerous case with a high risk of death due to abdominal infection, the doctors conducted an urgent consultation with multiple departments: emergency, gastroenterology, anesthesia and resuscitation... and proposed an emergency surgery plan to suture the perforation.
Dr. Nguyen Khac Diep, Department of Digestive Surgery, said that deciding to operate on an 85-year-old woman was a big challenge for surgeons. The patient also had many other underlying diseases such as cardiovascular disease, respiratory disease, and osteoporosis, making the choice of surgical option more difficult and complicated. Therefore, each step in the surgical process was consulted and planned in detail by doctors, from pre-anesthesia assessment, blood pressure control, to post-operative resuscitation, and close coordination between specialties.
Emergency surgery was quickly performed. During the surgery, the surgeons discovered a large amount of pus and pseudomembrane in the abdomen due to a 2cm perforation from the stomach pylorus to the anterior surface of the duodenum, on the background of a fibrotic ulcer. The surgeons quickly cleaned the abdomen, performed emergency surgery to suture the stomach-duodenum perforation, and took samples for pathological examination.
Immediately after surgery, the patient was transferred to intensive care for further monitoring of severe septic shock due to generalized peritonitis due to gastric and duodenal perforation.
Through this patient's case, Master, Doctor Nguyen Khac Diep recommends that people should not buy medicine to treat digestive diseases at home on their own. When unusual symptoms appear, they should immediately go to medical facilities for examination, diagnosis and timely treatment, especially in the elderly with many underlying diseases.
