On April 17, the designated hospital for the new crown treatment in Baoshan District of Huashan Hospital performed emergency endoscopic surgery for a 91-year-old man , and successfully removed the 4 dentures that were accidentally swallowed into the esophagus. At present, the elderly have been able to eat liquids and recovered well.
This 91-year-old new crown patient has underlying diseases such as diabetes and hypertension. In the early morning of April 15, due to swallowing four false teeth by mistake, he developed symptoms such as discomfort in the upper esophagus and pain in swallowing. According to the CT examination, the swallowed dentures were about 4 cm long and stuck at the entrance of the esophagus. Since the hospital in which he is located does not yet have the capacity for emergency surgery, the old man was transferred to the Baoshan District of Huashan Hospital for treatment after the coordination of the relevant higher-level departments.
Professor Qin Lunxiu, Executive Vice President of Baoshan Campus and Dean of Designated Hospital, and Professor Zhang Jiming, Executive Vice President, will coordinate the transfer of patients to the hospital as soon as possible, and contact Vice President Zhong Liang of Baoshan Campus. Dean. As the director of the Endoscopy Center in the hospital, Zhong Liang believes that the dentures have been stuck for 3 days, and the later the removal, the greater the risk! If the foreign body continues to cause damage to the surrounding tissue, it may cause perforation, bleeding, and even death from septic shock.
Multidisciplinary evaluation concluded that endoscopic therapy had the greatest benefit in 91-year-old patients compared with the high trauma of surgery. At the same time, Dr. Zhou Yi from the Department of Stomatology judged that the patient’s dentures were porcelain teeth with no hooks on both sides, and the damage to the surrounding mucosa during endoscopic removal was relatively small.
After deciding on the operation plan, Director Sun Xu, Dr. Jiang Xiaoyun, and Director Lin Dongfang of the Department of Gastroenterology of Baoshan Hospital quickly improved the emergency plan and obtained the informed consent of the family members.
Due to the close opening of the esophagus and airway, Dr. Feng Guangmin from the Department of Anesthesiology had a full preoperative evaluation, and Dr. Tang Xiaowei and Dr. Wu Cui completed the anesthesia.
The endoscopic surgery was performed by Zhao Xianguang from the Department of Gastroenterology and Jiang Hua from the Department of Nursing, assisted by Dr. Huang Jiaxin from the Department of Gastroenterology, Chen Ji from the Department of Thoracic Surgery, and Dr.
During the operation, the medical staff entered the mirror to the entrance of the patient’s esophagus, and could accurately observe that the dentures were stuck in the cervical stenosis, and the surrounding esophageal mucosa had obvious congestion and edema, forming ulcers. Because this section of the esophagus itself is extremely narrow, it is the most likely place for foreign bodies to get stuck, so the visual field is poorly exposed, and the operating space of the instrument is very narrow, especially when wearing a face screen and goggles, which affects the medical observation.
Under the remote video guidance of Vice President Zhong Liang, Dr. Zhao Xianguang steadily and accurately used foreign body forceps to determine the narrow groove on the upper end of the denture, and Nurse Jiang Hua quickly closed the instrument to clamp the foreign body. In order to prevent the esophagus from being scratched, the two gently and slowly drag the dentures to take them out. The whole process only takes 5 minutes, and the cooperation is quite tacit.
In order to prevent symptoms such as perforation after the removal of the foreign body, the medical staff entered the mirror again to observe the wound surface, and after confirming that there was no active bleeding and perforation, the gastric tube was indwelled, and the operation was ended.
The patient quickly woke up and was transferred to the ward after his vital signs were stable, and the operation was successfully completed.
Professor Qin Lunxiu, executive vice president of Huashan Hospital Baoshan District and director of the designated hospital, said that among the new crown positive infected patients currently admitted to the hospital, more than one third of the elderly patients over 70 years old have been , of which 25 are elderly patients over 90 years old, and most of them have other underlying diseases. In order to ensure medical safety and improve treatment capabilities, Baoshan Campus has completed the transformation into a specialization in accordance with the configuration of the original general hospital; established expert teams inside and outside the hospital to regularly conduct multidisciplinary online consultations for difficult and severe cases; for elderly patients, The hospital further increased the frequency of ward rounds, strengthened dynamic monitoring, and provided humanistic care.
Author: Tang Wenjia< /p>
Editor: Tang Wenjia
Responsible editor: Fan Liping
* Wenhui’s exclusive manuscript, please indicate the source when reprinting.