Changjiang Daily Wuhan Client May 26th 45-year-old Ms. He suffered a sudden ovarian rupture and twisting and left lower extremity thrombosis. Both emergencies need to be dealt with as soon as possible, which is a “dilemma” Problem, a late-night online MDT that brought together multidisciplinary experts gave the optimal solution in time, and solved Ms. He’s ills through interventional and gynecological surgery successively.
Ms. He, who lives in Jingzhou, was diagnosed with a large pelvic mass of 8 cm in the local hospital because of abdominal pain. After a week of treatment, the abdominal pain did not relieve, and a blood clot in the left lower extremity was also found. On May 16, she was transferred to the Guanggu District of Hubei Maternal and Child Health Hospital for treatment. Lian Hongmei, deputy chief physician of the Department of Gynecology, carefully examined and speculated that her pelvic mass had ruptured and reversed, and the B-ultrasound showed that it had grown to 15 cm and needed to be Surgery was performed as soon as possible, and thrombotic anticoagulation therapy was started immediately after admission. However, subsequent examinations revealed that Ms. He had more thrombosis in her left lower extremity than before, and she also suffered from diabetes and a family history of cerebral thrombosis.
The first treatment of thrombus requires observation for a period of time, which will delay the best time for the treatment of cyst torsion and rupture. If the acute abdomen caused by cyst is treated first, the thrombus may fall off at any time and endanger life. In the face of two “deadly” emergencies at the same time, this gynecological operation was suddenly in a dilemma.
Several subject specialists operate on patients.
Lian Hongmei and Duan Jie, the head of the Department of Gynecology of the Optics Valley Campus, decided to conduct a multidisciplinary consultation. Considering the emergency of the patient, this special MDT was arranged at 9:30 that night, and the heads of relevant departments such as gynecology, general surgery, adult intensive care, medical imaging, surgical anesthesia, laboratory and other related departments participated in the online meeting on time. , After an hour and a half of serious discussion and analysis, the experts gave two options, and prioritized the placement of the filter screen first to minimize the risk of thromboembolism, and to perform ovarian cyst surgery in a relatively short time.
The next day, Ms. Lan Weishun, deputy director of the Medical Imaging Department, successfully placed the left lower extremity thrombus filter. Duan Jie and Lian Hongmei jointly designed several pelvic mass surgery plans for her. , Lian Hongmei drew 7 sketches and explained the operation plan in detail for the patient.
Post-operative doctor rounds.
On the 17th, with the joint efforts of everyone, the cyst was safely removed and the operation was successfully completed. After ten days of multidisciplinary management, Ms. He was in stable physical condition and recovered well. He was discharged from the hospital successfully.
Lian Hongmei introduced that there have been many cases of ovarian cysts in recent years. She suggested that female friends should have a gynecological health examination every year. Doctors will give professional advice and recommendations based on age, reproductive needs and the nature of the cyst. (Reporter Li Qing of Changjiang Daily, Correspondent Huang Jieying and Luo Huarong)
[Editor: Yu Lina]
[Source: Changjiang Daily]