In a remarkable medical achievement, a team of doctors at King George's Medical University (KGMU) in Lucknow successfully treated a young man suffering from an exceptionally rare and deadly complication following a routine gallbladder operation. The 25-year-old patient developed a condition known as a cystic artery stump pseudoaneurysm, which posed a severe threat to his life due to sudden internal bleeding.
A Race Against Time After Routine Surgery
The patient had initially undergone a surgery to remove his gallbladder, a procedure known as cholecystectomy, at a different hospital on October 26 to treat gallstones. However, his health took a drastic turn. He was admitted to KGMU on November 8 with intense pain in the upper right abdomen, high fever, and persistent vomiting that had lasted for two days. Upon arrival, his condition was critical; he was pale, weak, and in a state of shock, clear indicators of significant internal blood loss.
Dr. Saumya Singh, a faculty member in the surgery department, highlighted the extreme rarity of this post-operative complication. "This is among the rarest complications seen after gallbladder surgery. Only about 60 to 70 such cases have been documented globally over several decades," she explained. "While rare, it is extremely dangerous because the bleeding often starts abruptly and is challenging to diagnose. We have encountered only one such case before this."
The Critical Emergency Intervention
The medical team sprang into action immediately, administering fluids and blood to stabilize the patient. Despite these efforts, his condition continued to deteriorate. His haemoglobin level—a crucial measure of the blood's oxygen-carrying capacity—plummeted to a dangerously low 5.2 g/dL, far below the normal range. This alarming drop necessitated rapid, large-volume blood transfusions.
As the bleeding persisted, an emergency open surgery was performed on November 15 to locate the source. The surgical team, led by Dr. Saumya Singh and including Dr. Nasir, Dr. Simon, Dr. Taukir, Dr. Prateek, Dr. Garima, and Dr. Saima under the supervision of Unit In-Charge Prof. JK Kushwaha, discovered nearly one litre of blood and clots in the abdomen, confirming the severe internal haemorrhage. However, fresh bleeding recommenced shortly after this procedure.
Minimally Invasive Technique Stops the Bleed
To pinpoint the exact source, doctors conducted a CT angiography, a specialized scan that visualizes blood vessels and active bleeding sites. This test revealed the culprit: a ruptured pseudoaneurysm in the stump of the cystic artery, a small vessel that once supplied blood to the gallbladder.
The interventional radiology team, headed by Prof. Manoj Kumar from the Department of Radiodiagnosis, then performed a minimally invasive, life-saving procedure. Using a thin tube inserted through an artery, they navigated tiny metal coils directly into the bleeding vessel. This technique, known as coil embolization, successfully blocked the vessel and halted the bleeding instantly, while carefully preserving the blood supply to the liver.
The patient received extensive post-procedure care in the intensive care unit, managed by the Anaesthesia and Critical Care services led by Dr. Brijesh Pratap Singh. After several weeks of meticulous monitoring and recovery, the young man was finally discharged on December 23.
A Triumph of Teamwork and Affordability
Prof. Soniya Niyanand, Vice Chancellor of KGMU, credited the patient's survival to the seamless, coordinated efforts of multiple departments, including Surgery, Radiology, Anaesthesia, Critical Care, and the Blood Bank. In a significant relief for the patient's family, who come from a financially underprivileged background, the entire cost of this complex, multi-stage treatment was kept remarkably low, between Rs. 5,000 and Rs. 10,000.
This case stands as a powerful testament to advanced medical expertise, swift interdisciplinary collaboration, and accessible healthcare, turning a near-fatal medical rarity into a story of survival.
