Mass bleeding, life-threatening
On April 21, Binh Dan Hospital said that the unit had just performed surgery to save patient N.T. B (female, 82 years old, Dong Thap) suffering from severe gastrointestinal bleeding.
Patient B was transferred to the emergency room in critical condition. Ms. B had severe abdominal pain, sweating profusely, pale mucous membranes and large amounts of fresh red blood (about 300 ml).
According to the family's account, in just 6 hours before that, the patient continuously had rapid and large amounts of blood in the stool.
At the Emergency Department, the indicators showed that the patient was suffering from severe bleeding, rapid pulse and low blood pressure. Doctors activated the resuscitation procedure. However, initial exploration methods did not accurately determine the location of the lesion.
Although 4 additional units of blood were transfused, Ms. B's clinical condition did not improve. Continuous blood loss in an elderly person with underlying diseases including hypertension, colitis and atherosclerosis puts the patient at risk of rapid death.
Multidisciplinary coordination
Doctors decided to perform emergency laparoscopic surgery to examine the abdominal cavity and find a place for bleeding from the outer surface of the digestive tract.
Dr. Nguyen Phu Huu - Head of the Department of Colorectal Surgery, Binh Dan Hospital, said that the surgery requires close coordination between specialist doctors. For the 82-year-old patient, doctors need to quickly find the location of the lesion in the shortest time to limit the risk of death due to acute blood loss in large quantities.
After more than 20 minutes of abdominal endoscopy exploration, the bleeding location was still undetermined. From CT-Scan images suggesting lesions in the rectum (minor intestine), doctors decided to remove the thick inflamed segment of the small intestine through a small hole on the abdominal wall.
From there, doctors can directly observe and coordinate with endoscopy in the digestive tract to find the bleeding location. After 20 minutes, a bleeding point due to ulcers at the end of the rectum was found.
General surgeons removed a 30 cm long ulcerated intestine segment, completely controlled the source of bleeding, and stitched the patient's digestive tract, preventing the patient from having to have an artificial anus.
1 day after surgery, the drainage situation stopped, vital signs stabilized and the patient did not need extra blood transfusions. After 9 days of treatment, Ms. B was discharged from the hospital.
According to Dr. Phu Huu, about 80% of cases of lower gastrointestinal bleeding occur in the colon and rectum. Usually, lesions in the small intestine are often caused by diverticles or tumors, easily detected by ultrasound. Mr. B's case is bleeding due to ulcerative enterocolitis, very rare (only accounting for 1% to 2% of cases).
Absolutely do not self-treat
Doctors recommend that gastrointestinal bleeding is a medical emergency with a high mortality rate if not treated promptly.
People need to monitor excretion signs: when diarrhea with blood (fresh red blood, bruised red or black stools), they need to go to medical facilities for examination. Especially, when there are symptoms of acute anemia such as dizziness, lightheadedness, rapid pulse, low blood pressure, they need to go to hospitals for immediate emergency treatment.
In older adults, symptoms may progress silently, but blood loss shock is very rapid due to underlying diseases of blood vessels.
Note that acute gastrointestinal bleeding cannot be cured at home. Late emergency care can lead to rapid death.
