18 year boy from a nearby village to Gannaur town District Sonepat, while driving a two wheeler, collided with a cart loaded with reinforced iron rods. Two iron rods of 40 feet (approx.) penetrated through the right side of his chest. The locals nearby cut the rod and patient came to Trauma Center, PGIMS, Rohtak, Haryana. The patient was immediately attended by team of doctors in Trauma...
18 year boy from a nearby village to Gannaur town District Sonepat, while driving a two wheeler, collided with a cart loaded with reinforced iron rods. Two iron rods of 40 feet (approx.) penetrated through the right side of his chest. The locals nearby cut the rod and patient came to Trauma Center, PGIMS, Rohtak, Haryana. The patient was immediately attended by team of doctors in Trauma centre and it was horrifying for the Patient and his family.
Team of specialist doctors from Cardio-thoracic Surgery and Cardiac Anaesthesia team came into action immediately and saved his life by performing the surgery. The challenge was to save his heart and large blood vessels. Surgery became further complicated since no CT scan or other imaging technology could be put to use because of long iron rods. Taking the greatrisk the case was the team of doctors discussed the case thoroughly and it was felt that he should be shifted to cardiac operation theatre for immediate Surgery as there was need of heart lung machine in event of fatal uncontrollable bleeding.
The patient was shifted immediately to cardiac operation theatre. The rod length was shortened by cutting the posterior part prior to induction of anaesthesia. The patient underwent exploratory
Patient with Rods through & through thoracotomy under ready femora-femoral cardiopulmonary bypass. the chest
The rods were found to be penetrating the Right upper lung and Right lower lobe.
The rods were extracted one by one very carefully not to damage nearby viscera. The lung injury at four sites was stapled using stapler gun to ensure that there is no air leak from lungs. The patient was extubated the very next day. Now he is doing well without any respiratory distress and chest X-ray showed normal lung fields.
This complex surgery was performed by team of doctors under the leadership of Professor & Head Cardiothrocaic Surgery Dr. S S Lohchab, Dr Sandeep Singh and Dr Frankleena. Cardiac Anaesthesia team consisted of Prof Dr. Naveen Malhotra and Dr Indra Malik.
Management of such types of impalement injuries is a challenging task when we know thatmost of the patient who unfortunately gets such injuries do not reach hospital even. Under such circumstances the expert has the opinion that removal or movement of penetrating rods under such circumstances should not be attempted as it may lead to further damage and haemorrhage. These patients need expert team consisting of general surgery, cardio-thoracic surgery and cardiac anaesthesiain the facilities like in Lala Shyam Lal Super speciality Hospital with in the campus of PGIMS Rohtak. Govt is spending enough of the resources and pubic money to create such facilities in the govt sector as in the private set up such surgeries will cost a huge money.
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