Saving an old man’s life with a perforated stomach and an abdominal abscess

On May 6, news from Hoan My Cuu Long General Hospital said that the hospital’s doctors promptly saved an old man’s life with chronic obstructive pulmonary disease. perforation of the stomachabdominal abscess and many associated diseases.

Before that, Mr. CNN (87 years old, living in Can Tho City) was hospitalized with difficulty breathing, coughing, and sputum production due to a history of chronic obstructive pulmonary disease (COPD) group D, pulmonary sequelae, hypertensionheart failure.

Doctor examines patient CNN PHUONG CHI

Through examination and performing paraclinical techniques, the doctor discovered that a contrast foreign body in the digestive tract 34 mm x 2 mm long (1 end in the antrum, 1 end in the back wall of the stomach) created a large abscess. .

The patient was diagnosed with a gastrointestinal foreign body causing gastric perforation with complications such as: Abdominal abscess, sepsis. In addition, the patient also had COPD, hypertension, heart failureischemic heart disease, acute renal failure.

After consultation, the medical team decided to endoscopically pick up the foreign body and combine surgery, drain the abscess to save the patient’s life overnight with appropriate antibiotic treatment, anti-inflammatory bronchiectasis, respiratory support. respiratory, active cardiovascular. This is a surgical case where the risk respiratory failure Severe progression during and after surgery is very high.

During the treatment, the doctor aspirated 200 ml of cloudy pus, placed a drainage and cultured the fluid as an antibiotic. After surgery, due to the worsening of COPD, the patient was transferred to the respiratory department for intensive treatment. After the hospital stay, the patient gradually regained consciousness, no longer had abdominal pain, reduced shortness of breath, eating and drinking almost returned to normal.

MSc Nguyen Huu Ky Phuong, Head of Gastroenterology Department, Hoan My Cuu Long General Hospital, said that gastrointestinal foreign bodies are common in the elderly due to tooth loss, reduced chewing ability and poor vision. The most effective and safe treatment method is pick up foreign body through endoscopy. However, some cases of late arrival to the hospital have complications of gastric perforation, abdominal abscess like the above case, requiring timely treatment, the doctor must have a lot of experience and good postoperative resuscitation. .