Renji's multidisciplinary team jointly performed emergency surgery in the early morning to successfully treat a patient with nasopharyngeal cancer who suffered two major hemorrhages late at night.
critical! Late at night, a 53-year-old nasopharyngeal cancer patient suffered a sudden massive hemorrhage and faced life-threatening danger. The multidisciplinary medical team of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine quickly identified the cause of bleeding, took quick action in the early morning, performed emergency surgery, and successfully saved lives.
Ms. Wang has been suffering from nasopharyngeal cancer for 8 years. Her condition was stable before. Unexpectedly, late one night recently, while she was resting at home, she suddenly discovered that she was bleeding heavily in her nasal cavity and the blood flow was not stopping. The family members immediately sent him to the emergency department of Renji Hospital. The nurse at the pre-examination desk found that Ms. Wang was in poor condition, pale and in critical condition, and immediately called the otolaryngology department.
After receiving the diagnosis, the otolaryngologist, taking into account Ms. Wang’s history of nasopharyngeal cancer, immediately realized that there may be serious damage to the nasal bone, leading to carotid artery damage and massive bleeding. Therefore, the neurosurgery department and radiology department were immediately called for consultation and discussion. In order to quickly diagnose the cause of the disease, the emergency green channel was opened immediately. Ms. Wang quickly completed a head CTA examination. Based on the examination results, the consultation expert team believed that Ms. Wang might be bleeding from a carotid artery pseudoaneurysm.
Carotid pseudoaneurysm bleeding is a rare but very dangerous disease. Re-rupture of the aneurysm may cause severe bleeding at any time and endanger the patient's life. Emergency surgery is necessary to save life.
An emergency operation began. The expert team quickly contacted the anesthesiology department and operating room to initiate emergency surgery.
However, misfortunes never come singly. Just as the neurosurgeon was making preoperative preparations, Ms. Wang suffered another massive nasopharyngeal bleeding, and soon developed symptoms of a drop in blood pressure, confusion, and body chills. The atmosphere in the emergency hall was tense. Dr. Ren Nana from the otolaryngology department took emergency measures decisively, compressing and packing the front and back nostrils. The nurses in the emergency department opened intravenous channels, performed emergency blood transfusions, and accelerated the infusion and volume expansion to stabilize Ms. Wang's vital signs. , to buy time for surgical rescue and emergency transfer to the hybrid operating room.
Since both the front and back nostrils were filled to stop bleeding, the anesthesiologist concluded that endotracheal intubation was impossible, and the operation faced difficulties again. In order to reduce the risk of re-bleeding from the aneurysm, Zhao Bing, deputy chief physician of the Department of Neurosurgery, discussed with Dr. Zhu Hao of the anesthesiology department and his family members and decided to perform aneurysm surgery under local anesthesia under anesthesia supervision.
The operation lasted from 1 a.m. to about 3 a.m. Zhao Bing's team comprehensively assessed the patient's cerebral blood flow compensation, clarified the bleeding location of the pseudoaneurysm, and accurately performed carotid artery revascularization to ensure carotid artery blood flow. Patents and heals the aneurysm, reducing the risk of carotid artery bleeding and large cerebral infarction.
The operation was completed, and Ms. Wang was safely transferred to the neurosurgery intensive care unit for continued treatment. She was conscious and had stable blood pressure after the operation. Two days later, the nostril packing was removed and Ms. Wang could eat normally.
After a week of treatment, the medical staff in the intensive care unit gradually corrected Ms. Wang's severe anemia, hypoalbuminemia, malnutrition and other complications. Ms. Wang's condition gradually stabilized and she recovered and was discharged.
Massive nasopharyngeal bleeding is very dangerous and life-threatening. Patients with symptoms of nasopharyngeal bleeding must not take it lightly. Pan Yaohua, chief physician of the Department of Neurosurgery, said that for sudden massive bleeding, the possibility of carotid artery pseudoaneurysm should be considered. Through multidisciplinary collaboration and emergency treatment measures, late-stage bleeding from nasopharyngeal cancer can be effectively controlled and lives saved.
Nasopharyngeal cancer is a common head and neck tumor that occurs in the epithelial tissue of the nasopharynx. Early symptoms are not obvious and can easily be ignored, requiring early detection and treatment. Experts remind that in the late stage, the prognosis of nasopharyngeal cancer is usually more serious, and serious complications may occur. One of them is massive bleeding in the nasopharynx. The situation becomes urgent and may cause difficulty in breathing, suffocation, or even life-threatening. Therefore, it is necessary to Take prompt measures for treatment. In addition to surgical treatment, other treatment measures such as radiotherapy and chemotherapy can also be used to control late-stage symptoms or bleeding of nasopharyngeal cancer.
