Nagpur: Orange City Hospital & Research Institute caters to huge number of complex Critical patients, like accidents, poisoning, medical emergencies and medico-legal cases etc. OCHRI has a full-fledged Critical care unit with dedicated 40 bedded ICU with NICU/PICU with state of the art equipment with related diagnostic facilities under one roof managed by round the clock full time stationed Intensivists.
On September 27, 2016 at around 9:30 pm, a 71 years old man resident of Wardha referred from Sewagram rushed to Casualty, Orange City Hospital & Research Institute with complaints of vomiting, severe pain in abdomen, breathlessness, high grade fever and sepsis which had increased since 3 days. He was immediately attended by Dr. Deepak Narwade- CMO, Dr. Ganesh Bure- Stationed Intensivist and Dr. Rajesh Atal- Critical Care Physician. On examination, patient was noted to be pulseless, in toxic Shock, with low BP with high heart rate, having difficulty in breathing with excruciating abdominal pain. Initial management of shock and septicemia management was started and he was taken immediately for investigations.
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His X -rays were suggestive of Dextrocardia (Heart on Rt. Side) which is an extremely rare congenital condition and occurs in less than 1 % of general population with suspicion of gas under diaphragm.
Immediately Dr. Mukund Thakur, renowned Senior Minimal Invasive Surgeon rushed in and looking at the condition of patient decided to do the surgery immediately in late night hours. Even consent for death on table was taken from relatives.
On opening abdomen Surgeon was surprised to see that stomach was pushed into Thorax from a hiatus hernia. Stomach had even twisted inside the chest cavity and became gangrenous which was even perforating in thorax pushing the heart to Rt. Side. Dr. Mukund Thakur performed the delicate challenging surgery by pulling down the stomach in abdominal cavity, removing the gangrenous portion, closing the perforations, conducting lavage (cleaning of thorax and abdominal cavity) and hiatus hernia was also repaired. Dr. Neeta Deshpande provided the necessary anesthesia and Sr. Jyotika Uikey assisted during surgery.
Post-operative chest x-ray was normal with heart on lt. Side. After the surgery he was put on ventilator support in ICU which was gradually weaned off. Presently this patient’s vital parameters normal and he is on course of recovery.
Dr. Milind Pande- Pathologist and Dr. Nishikant Lokhande – Radiologist rendered timely diagnostic support while Dr. Nikhil Balankhe, Senior Critical Care Physician led the team of full time round the clock stationed Intensivists consisting of Dr. Ashish Shukla, Dr. Rani Lakhe, Dr. Roshan Jawdekar, Dr. Santosh Gadge, Dr. Saurabh Rathi, Dr. Vasundhara Jain and Dr. Ganesh Bure to provide critical care support. Dr. Anit Prakash supervised the treatment in wards while Dr. Kavita Dhurvey assisted Dr. Mukund Thakur in managing the post-operative care. Ambika Nair, Preeti Joseph and Savita Shende led nursing & paramedical team in Operation theatre, Critical care unit and wards while Dr. Sanil Koyili led the team of Physiotherapists.
On behalf of OCHRI family; Dr. Anup Marar, Director-OCHRI complimented Dr. Mukund Thakur, Dr. Nikhil Balankhe and Dr. Rajesh Atal who led OCHRI team of doctors, nursing and paramedical team and rendered timely decisive comprehensive care that snatched this 71 old man back from jaws of death.
On this occasion Dr. Mukund Thakur modestly stated that backup of an excellent team work including timely diagnosis, intricate anesthesia rendition, quality investigations, advanced OT & CCU infrastructure, dedicated round the clock manpower and total faith of relatives helps a surgical expert to contemplate such daring complex surgery.
