KGMU doctors treat life-threatening complication after gallbladder surgery | Lucknow News

Lucknow: Doctors at KGMU successfully treated a 25-year-old man who developed an extremely rare and life-threatening complication called cystic artery stump pseudoaneurysm after gallbladder surgery performed at another hospital, officials said.Doctors explained that in this condition, an abnormal balloon-like swelling develops in a small vessel supplying blood to the gallbladder. If it bursts, it can cause sudden and massive internal bleeding.

The patient was admitted to KGMU on Nov 8 with severe pain in the upper right side of the abdomen, fever, and repeated vomiting for 2 days. He underwent gallbladder removal surgery on Oct 26 for gallstones at another hospital. When he reached KGMU, he was pale, weak, and in shock, a sign that he was losing a large amount of blood internally. Dr Saumya Singh, faculty at the surgery department, said the condition is among the rarest complications seen after gallbladder surgery. “Only 60–70 such cases have been reported worldwide over several decades. Though rare, it is extremely dangerous because the bleeding often starts suddenly and is difficult to detect. We have also seen only one such case earlier,” she said. “We immediately started emergency treatment, giving the patient fluids and blood. Despite this, his condition worsened, and his haemoglobin level, which shows the oxygen-carrying capacity of blood, dropped to 5.2 g/dL, far below normal. This led us to begin rapid and large-volume blood transfusions,” she said. As bleeding continued, she, along with team members Dr Nasir, Dr Simon, Dr Taukir, Dr Prateek, Dr Garima, and Dr Saima, under the supervision of Unit In-Charge Prof JK Kushwaha, performed an emergency open surgery on Nov 15 to locate the source. During the operation, nearly 1 litre of blood and clots was removed from the abdomen, confirming severe internal bleeding. However, soon after surgery, fresh bleeding started again. They then carried out a CT angiography, a special scan that shows blood vessels and active bleeding. This test revealed that the bleeding was coming from the ruptured cystic artery stump. The interventional radiology team, led by Prof Manoj Kumar (Radiodiagnosis), then performed a minimally invasive procedure in which tiny metal coils were placed inside the bleeding blood vessel through a thin tube inserted via an artery. This blocked the vessel and stopped the bleeding while keeping blood supply to the liver intact. The bleeding stopped immediately. Anaesthesia and Critical Care services, on call, headed by Dr Brijesh Pratap Singh, provided help in the procedure and intensive care for several weeks. He was discharged on Dec 23. Prof Soniya Niyanand, vice chancellor of KGMU, said the patient survived due to coordinated efforts by surgery, radiology, anaesthesia, critical care, and blood bank teams. As he came from a financially underprivileged background, the total cost of treatment was kept low at Rs 5,000–Rs 10,000.