Conquest of Death 2

CONQUEST OF DEATH 2
(BURIED IN THE RUBBLE)
(FECAL PERITONITIS)‘It’s already two and a half hours! How long would you take?’, the anesthesiologist was grumbling.
I was engrossed in the operation. So I ignored her. ‘It would be unsafe to continue giving anesthesia for a longer time----‘ I was alarmed. With the sense of a surgeon’s duty and compassion, I said, ‘Isn’t it equally unsafe to leave injuries untreated, especially perforations? It’s criminal!’ ‘Patients of fecal peritonitis do not survive! She already has contracted fecal peritonitis!! (Feces infecting the sac in which the intestines are contained)’, the anesthesiologist emphasized. ‘For want of better drugs to combat infections, for lack of better supportive measures in the hands of medical fraternity to manage septic shock, let her die, but certainly not for surgical negligence and not treating these injuries like perforations!’ I said.
An elderly lady was buried in the rubble following collapse of the roof of her house. She had sustained abdominal trauma. On the operating table, I found that she had many perforations in the small and the large bowel. There were no other injuries. I had almost finished the operation when the anesthesiologist alarmed me. Only the colostomy procedure (bringing the large bowel out of the abdominal cavity and subsequently opening it to empty the fecal matter), was remaining. I soon completed that and caught a last glimpse. ‘Nurse, peritoneal lavage please!’ I said. Peritoneal lavage refers to washing of the sac covering the intestines.I inserted two catheters, one each in the iliac fossae for postoperative lavage and closed the abdomen. After shifting the patient in the ward, I gave her relatives an idea of the gravity of the situation.
In the ward I administered intravenous fluids, antibiotics, peritoneal lavage, etc. Two days later, her restlessness disappeared. Her vital signs became stable. Later, her colostomy started functioning. The sepsis was controlled. There was no wound infection. She started accepting oral feeds. On the tenth postoperative day, I removed the sutures. She was moving around cheerfully in the ward. Three weeks later, I closed the colostomy. In due course of time she went home!!


A TRUE STORY IN REAL LIFE!
A DRAMA IN MY LIFE!!
DR. HEMANT VINZE

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