Saving the life of a patient with severe gastrointestinal bleeding and circulatory collapse due to duodenal ulcer

Patient Dam Van V. (61 years old) in Nam Dan, was hospitalized with abdominal pain after eating, the pain was dull, sometimes cramping, cyclical, accompanied by black stools.

Doctors performed an endoscopy of the esophagus, stomach, and duodenum and discovered that the back of the duodenum had an ulcer covering half of its circumference, spurting blood, and the stomach had many blood clots.

The doctors of the endoscopy department coordinated with the gastroenterologist of Bach Mai Hospital (who was participating in the examination at Cua Dong Hospital) to perform a hemostatic clip intervention, then clamped and injected to stop the bleeding, but the condition did not improve. The patient continued to have episodes of blood spurting from the bottom of the ulcer, and experienced circulatory shock, pale skin and mucous membranes, low blood pressure, and a rapid, weak, and difficult-to-detect pulse.

The hospital's professional team quickly consulted and diagnosed the patient with circulatory shock due to severe gastrointestinal bleeding due to duodenal ulcer and decided to perform emergency surgery to save the patient's life.

The professional team of Cua Dong General Hospital performed emergency surgery on patient Dam Van V. Photo: Cao Phuong

The patient was treated with intravenous fluids, blood pressure was raised, red blood cells of the same group were collected, and he was transferred directly to the operating room.

During the surgery, the doctors discovered a large fibrotic ulcer behind the duodenum, deformed and causing pyloric stenosis. There was a lot of black blood in the stomach and small intestine. When the stomach was opened, the ulcer had perforated the gastroduodenal artery and was spurting blood. The doctors ligated the gastroduodenal artery, sutured the base of the ulcer to stop bleeding, removed all the blood clots in the stomach, cut off 2/3 of the stomach and transfused 7 units of packed red blood cells, frozen plasma, protein, and fluid replacement for the patient.

With the cooperation of the entire team, the surgery was successfully performed after two and a half hours. After the surgery, the patient was awake, regained mobility, and vital signs and tests were all within normal limits. The patient is expected to be discharged in the next few days.

With the cooperation of the entire team, the emergency surgery was successfully performed after two and a half hours. Photo: Cao Phuong

Master, Doctor Thai Doan Cong - Head of Surgery Department, Cua Dong General HospitalGastrointestinal bleeding is an emergency disease, requiring early diagnosis, finding the bleeding point to stop the bleeding and active treatment.

Symptoms include vomiting red blood, blood clots, dark brown mixed with food, black stools, loose like coffee grounds, foul smelling. Depending on the level of blood loss, symptoms include sweating, cold hands and feet, pale skin and mucous membranes, restlessness, fainting, low blood pressure, rapid and weak pulse, rapid and shallow breathing, little urine...

After surgery, patient Dam Van V. recovered well. Photo: Cao Phuong

When there are signs of suspected gastrointestinal bleeding, accompanied by epigastric pain, pallor, dizziness, etc., the patient needs to see a doctor immediately for timely diagnosis and treatment./.