Excelsior Correspondent
KATRA, June 18: A 55-year old man with complaints of blood in stools, jaundice and generalized weakness was treated successfully at Shri Mata Vaishno Devi Narayana Superspeciality Hospital.
The man got admitted from Emergency of the hospital after initial resuscitation under Dr Nikhil Mahajan, Consultant Gastroenterology and his team. He was transfused 4 units of blood. After initial stabilisation, Upper GI endoscopy performed by Dr Nikhil Mahajan showed blood coming from papilla (opening of bile duct and pancreatic duct).
CT Angio abdomen showed a large 4 cm pseudo-aneurysm (blood filled sac with impending rupture) of a blood vessel (GDA) communicating with Pancreas duct (PD) causing pain and GI bleed. Pseudo aneurysm also caused bile duct (duct from where bile juice comes to digest food) compression causing jaundice.
Options of major surgery for it vis-à-vis interventional radiology occlusion of pseudo aneurysm (expertise not available in hospital) vis-à-vis endoscopic intervention were discussed with attendants in detail and endoscopic drainage (incision less) of pseudo aneurysm was planned.
It involved Endoscopic ultrasound (ultrasound attached to tip of endoscope) assessment of the lesion followed by puncturing the blood filled sac with needle under vision and then injecting a glue like substance in it which not only occludes the blood sac but also blocks the feeding vessels.
Procedure was conducted successfully under conscious sedation and was completed with out any complications in 15 minutes. The patient was discharged one day after the procedure.
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