A six-year-old boy from Bihar who reached Lucknow with a severely torn liver and nearly two litres of blood accumulated inside his abdomen, has survived after emergency surgery and intensive multidisciplinary trauma care at the Apex Trauma Centre of Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS).
After 18 days at the Apex Trauma Centre, he was discharged on August 19 in satisfactory condition.
Krishna Kumar, a resident of Gopalganj district in Bihar, was hit by an e-rickshaw on July 29. He was subsequently referred to the Apex Trauma Centre and admitted on August 1.
Doctors found a Grade IV liver injury, one of the more severe categories of blunt liver trauma. With the bleeding continuing, doctors had to take the child for emergency surgery the same day.
The Trauma Surgery team, led by Prof Amit Kumar Singh, additional chief, Apex Trauma Centre, with senior resident Dr Aditya Singh, operated on the child to control the bleeding and stabilise the damaged liver.
Following the operation, the child required mechanical ventilation for around 48 hours and remained under close observation in the trauma centre.
The postoperative period was equally crucial. Doctors monitored the child for recurrent bleeding, infection, respiratory complications and other problems associated with major abdominal trauma.
{{/usCountry}}The postoperative period was equally crucial. Doctors monitored the child for recurrent bleeding, infection, respiratory complications and other problems associated with major abdominal trauma.
{{/usCountry}}After being weaned off ventilatory support, Krishna showed gradual clinical improvement. He continued to receive multi-disciplinary care and monitoring until doctors considered him stable enough to leave the hospital.
The case also highlights the importance of recognising internal bleeding after road accidents. A patient may not always have dramatic external injuries even when significant bleeding is occurring inside the body.
A Grade IV liver injury with active bleeding is a potentially fatal trauma, particularly in a young child. Such injuries can rapidly lead to haemorrhagic shock and require immediate access to trauma surgery, anaesthesia, blood-loss management and intensive care.
The child was referred from Bihar to Lucknow for specialised trauma management, underlining the role of the SGPGIMS Apex Trauma Centre as a referral facility for patients with complex injuries from Uttar Pradesh and neighbouring states.
The successful outcome, doctors said, was the result of rapid assessment, emergency surgical control of bleeding, advanced anaesthesia, ventilatory support and continuous postoperative monitoring.
For Krishna, however, the numbers tell the story most starkly: a July 29 road accident, a Grade IV liver injury, nearly two litres of internal bleeding, emergency surgery on August 1, 48 hours on a ventilator—and finally, walking out of the trauma centre on August 19.