Elderly Bahraini woman saved from blood poisoning due to a ruptured bowel

Brought to the hospital in a severely critical condition, 77-year-old Bahraini woman found a fresh lease to life after suffering from blood poisoning due to ruptured bowel and multiple organ failure. The elderly lady was rushed to Bahrain Specialist Hospital’s emergency department, complaining of acute abdominal pain and distention. She was immediately assessed and diagnosed with a hole in her colon (colonic perforation) which was causing septicemia or blood poisoning.

The case was all the more serious since the patient had suffered a fall 10 days ago and was already being treated for rib fractures which compromised her mobility.

Explaining the challenges in the surgery, Dr Manish Madnani, an expert in Gastrointestinal, Liver and Pancreas Surgery at Bahrain Specialist Hospital said: “It was a critical case that required immediate action since it posed many issues. Firstly, the patient was obese which made the dissection difficult. She was also very old and her condition was rapidly deteriorating because of sepsis as the colonic bacteria had spread to her abdomen. Once sepsis sets in the bloodstream – a condition called septicemia – it presents a very dangerous situation and is difficult to treat. Her immunity had reached a very low level so she was very vulnerable to infection, the blood pressure was constantly falling and her body was in shock due to septicemia”.

Moreover, the patient’s multiple rib fractures and her various other illnesses such as diabetes, hypothyroidism, hypertension, cervical disc and other bone and joint related problems made the surgery extremely difficult and life-threatening.

Dr Madnani added: “Though we were at odds, we decided to take the patient for immediate surgery in which the affected part of the colon was removed and an artificial opening of intestines was created on her abdomen. This is required in such emergency and life-threatening conditions to save time and to allow adequate healing of intestines.”

In all, the surgery took five hours to complete.

Although in certain circumstances intestines can be repaired at the same time, it is not advisable in cases of shock and in elderly. In fact, despite maximum efforts, it is very difficult to save such patients due to the many perioperative complications which can set in, including infections in lungs and abdomen, in blood, blood clots in deep veins of legs and lungs, heart problems and many others.

“In this case, there were several post-operative issues to counter. Because her immunity level was dangerously low, we had to not only control the source of infection but also fight the infection which already existed in her body. The patient took a few days to recover from multiple organ failure, which itself was a huge achievement since there’s only 50 percent chance of survival in such cases. We kept her on a ventilator for around 7 days, and during that time all her vital organs were provided external support to work properly,” said Dr Madnani.

Fortunately, the patient was able to overcome these complications courtesy the competent team of doctors, nurses along with the paramedics at BSH. She recovered rapidly and was able to go home thanking the hospital for timely and efficient treatment.

Commenting on the successful treatment, Dr Kasim Ardati, Managing Director of Bahrain Specialist Hospital and Clinics said: “A surgery as complicated as this requires a high level of skill and expertise, particularly among the elderly. I’d like to congratulate the team on taking on such a challenging case which was already riddled with so many earlier health issues, and confidently doing their job successfully. Hepatobiliary surgeries, that is, surgeries involving liver, pancreas, gall bladder and bile duct are a niche speciality, and we take pride in the fact that at BSH, we have a capable team to deal with any of such kinds of complicated procedures as amply proven by this case. ”