Correspondent: Liu Fang
The steel nails shot from the steel nail gun can pass through thick steel plates and concrete walls, and its power is self-evident. Recently, 47-year-old Mr. Yang (pseudonym) was accidentally stabbed into his body by a steel nail gun during his operation, and the steel nail penetrated the chest cavity of the injured person and entered the abdominal cavity. The multidisciplinary experts of our hospital urgently gathered for consultation and successfully removed the steel nail for him through joint surgery, which saved the danger and ensured the patient's life.
A steel nail More than a dozen experts gathered
On May 4, Mr. Yang was rushed to the emergency department of the East Hospital of Qingdao Municipal Hospital by 120 emergency personnel. The attending doctor quickly determines the condition, arranges an examination and asks the relevant department for consultation. Through examination, it was found that the right chest wall of the self-injured person penetrated the chest cavity, passed through the liver and kidney, and finally pierced into the psoas muscle close to the transverse process of the second lumbar vertebra, causing rib fracture and bleeding in the liver, kidney, perirenal and other parts. Trauma involves multiple vital organs, the situation is urgent, and if left untreated, serious complications such as massive bleeding and infection may occur.
The Emergency Department of the Eastern Hospital quickly reported to the Medical Department and initiated a hospital-wide multidisciplinary consultation. Emergency Department, Thoracic Surgery, Urology, Spine Surgery, Colorectal Surgery, Hepatobiliary and Pancreatic Surgery, Anesthesiology, Imaging...... More than 10 department directors and experts gathered, and Vice President Yuan Rongtao urgently dispatched the rescue and carried out two hospital-wide consultations and discussions.
Relevant examinations found that although the steel nail was close to Mr. Yang's spine, it did not penetrate into the vertebrae, and at the same time, it also avoided the larger blood vessels in the hilum and pedicle of the liver, and although the kidney ruptured and bleeding, and the liver had contusion and laceration, there was no uncontrollable active bleeding. However, the steel nails are close to the lumbar spine and there are important nerve fibers nearby, so the surgical removal process needs to be extra careful, once the nerve damage is caused, it will affect the function of the patient's lower limbs.
The expert team finally determined a multidisciplinary diagnosis and treatment plan combining urology and spine surgery, and perioperative treatment led by emergency ICU, and chose a more minimally invasive laparoscopic surgery to minimize the trauma of patients as much as possible.
Combined minimally invasive surgery and multidisciplinary relay treatment
During the operation, Liu Haifei, director of the Department of Spine Surgery of the Eastern Hospital, accurately positioned the position of the steel nail under the guidance of the C-arm machine according to the preoperative image, and Jia Yong, deputy director of the Department of Urology, who is good at retroperitoneal laparoscopic surgery, established the retroperitoneal space, removed the retroperitoneal fat, opened the perirenal fascia, removed the blood clot around the kidney and in front of the psoas muscle, and fully exposed the psoas muscle, and found the steel nail and took it out safely in less than 30 minutes. After the operation, the patient returned to the emergency ICU for further treatment, and the function of both lower limbs was normal.
The efficient multidisciplinary joint rescue mechanism, exquisite surgical technology, and meticulous perioperative comprehensive treatment have saved the danger for this worker who was hit hard during Labor Day, and demonstrated the comprehensive treatment ability of our hospital as a provincial trauma center.
It is understood that after comprehensive treatment such as emergency anti-infection and liver protection, the patient is currently recovering well and will be discharged from the hospital in the near future. Recalling this thrilling experience, Mr. Yang felt palpitations and was deeply grateful: "It's so thrilling, thanks to the municipal hospital, so many experts bothered about my injury, I really appreciate it!" ”