Qilu Evening News Qilu One Point reporter Xu Liang correspondent Li Mengjiao
Received two cases of liver rupture in one week , and were more bleeding shock, at stake. The medical and nursing team of Shandong University Qilu Hospital Dezhou Hospital cooperated closely and successfully saved two lives. On February 15, in the pediatric surgery ward of the hospital, both children resumed their normal diet and will be discharged soon.
On the afternoon of January 24, an 8-year-old boy was hit by a car in the abdomen and was sent to the emergency department of Shandong University Qilu Hospital Dezhou Hospital, looking pale and in a trance! The medical staff urgently checked the blood routine, abdominal color Doppler ultrasound, CT… The child had low skin temperature and abdominal distention, and the medical staff did not coagulate the blood when performing abdominal puncture for him, which indicated that the child had active bleeding in the abdominal cavity, that is, there was blood Stopped to flow out of the injured blood vessel, consider hemorrhagic shock, liver rupture. So, get a blood transfusion immediately to correct the shock!
“The liver is one of the most frequently involved organs in abdominal trauma, which can cause hemorrhage and biliary tract injury. The main clinical manifestation is abdominal pain. The condition is acute and develops rapidly. This child is caused by liver rupture and hemorrhage. If the hemorrhagic shock cannot be controlled, it can be life-threatening, and surgery is the first choice for treatment.” Liu Tao, deputy director of pediatric surgery, said that the child’s condition continues to worsen, and there is no extra time for doctors to consider and hesitate, “immediate surgery can save lives. “!
After Sun Hongqiang, the attending physician of pediatric surgery, explained the condition and treatment plan to the boy’s mother, the mother was in tears and agreed to operate immediately. During the emergency rescue in the emergency department, the doctor immediately contacted the department of anesthesia and surgery to prepare life support equipment such as autologous blood transfusion devices in advance… After the green channel was opened, the child was directly pushed into the operating room, and the medical and nursing team of the department of anesthesia and surgery provided the child with General anesthesia with endotracheal intubation, establishment of central venous access, and invasive blood pressure monitoring were urgently performed. Dr. Liu Tao’s team urgently performed surgery on the child.
A large amount of intra-abdominal hemorrhage was seen during the operation. The exploration found that the left inner lobe of the liver and the left outer lobe of the liver were completely ruptured, and the left hepatic vein and some important branches were ruptured. , The bleeding was ferocious, and vascular suture repair was immediately given, as well as debridement and repair of the left hepatic lobe. Exploration of other organs in the abdominal cavity showed no obvious damage, and a total of nearly 2000 ml of intra-abdominal bleeding was aspirated during the operation.
“The total blood volume of such an old child is only 2100-2400ml. With the strong cooperation of pediatric surgery, emergency department, blood bank, operating room, etc., we can transfuse blood and correct shock as soon as possible. Surgery, and the use of autologous blood reinfusion device, can reduce allogeneic blood transfusion, reduce complications, and ultimately save lives!” Liu Tao said that the operation went smoothly, and the child was transferred to the children’s intensive care unit for treatment after 3 days, and the condition was stable after 3 days. transferred to the pediatric surgery ward.
On January 30, an 8-year-old girl accidentally fell while swinging and suffered from abdominal pain for 5 hours. She was sent to the emergency department of Dezhou Hospital, Qilu Hospital of Shandong University. The emergency department immediately checked blood routine and abdominal color Doppler ultrasound. Wait. Liu Tao immediately went to check. The child was pale, had a distended abdomen and was in shock. After a diagnostic abdominal puncture, it was found that the child had active bleeding in the abdominal cavity, and liver rupture was considered. Liu Tao immediately contacted the blood bank for blood preparation and blood transfusion. After the family members agreed to the operation, the hospital opened the green channel as soon as possible and pushed the child directly into the operating room. During the operation, 1500ml of hemoperitoneum was seen, and the exploration found irregular lacerations of segments VI, VII, and VIII of the right hepatic lobe, the deepest 8 cm, and part of the liver was completely ruptured from the septal surface to the visceral surface, accompanied by active bleeding. Dr. Liu Tao’s team gave abdominal organs Exploration of liver rupture debridement and repair, the operation went smoothly. The child was safely returned to the ward after the operation, and continued to correct shock, blood transfusion, and prevent infection after operation, and the child recovered smoothly.
Liu Tao introduced that most children’s liver ruptures are caused by trauma, and most of them can be treated conservatively. For example, two cases require surgery within a week, and it is rare for them to have severe liver damage of grade IV or above. The patient’s recovery is still inseparable from the careful care of the nursing team. “The child is recovering well, and the head nurse Niu brought us hot dumplings on the first day of the new year, which made us feel the warmth of home.” The boy’s mother gave a thumbs up to the superb medical skills and thoughtful service of the medical staff.
As a municipal key specialty, Pediatric Surgery, Qilu Hospital Dezhou Hospital of Shandong University, has continuously accelerated the construction of talent teams, focused on improving medical technology and service level, and took the lead in carrying out high-precision minimally invasive surgery in the city. At present, it has been able to independently carry out various surgeries within the specialties of thoracic surgery, general surgery, urology and bone surgery for children aged 0 to 14 years.