A 32-year-old Mohammed from Ethiopia’s life was shattered when he was diagnosed with 1.25 kg of tumor in his abdominal cavity. This led to the displacement of internal structure in his stomach. The operation was risky as the tumor was entangled between his splenic artery (blood vessel supplying oxygenated blood to the spleen), left gastric artery and hepatic artery (distributes blood to the pancreas, liver and gallbladder).
Dr. Vivek Vij and Dr. Sanjay Verma from Fortis Hosptial along with their team performed this challenging surgery. After getting the complaints of abdominal swelling, he underwent gastrointestinal endoscopy, which confirmed the diagnosis. Following this, he underwent an Exploratory Laparotomy for the excision of the tumor.
Dr. Vivek Vij said, “The complexity of this case lies in the fact that retroperitoneal tumor was densely stuck to celiac plexus and arteries from spleen and liver. In such situation, a complete excision was not possible normally; it could injure spleen and hepatic artery. If a hepatic artery is injured while removing the tumor, the blood supply of liver will go and it will lead to vascularity of major portion of liver and if spleenic artery is injured, splenectomy needs to be done. As a result, splenic artery was sacrificed and hepatic artery was re-implanted at celiac axis. This is a rare procedure, undertaken by a few hospitals.”
In a statement issued by the hospital, Dr. Sanjay Verma said, “Before surgery, a USG Color Doppler test was used to confirm the normal flow of blood in the celiac axis and the hepatic artery and the vascularity of the spleen. The patient tolerated the treatment satisfactorily. He was discharged on the fifth day and is doing fine now.”
The celiac artery is the major branch of the abdominal aorta. Symptoms of celiac artery compression are nonspecific, including nausea, vague upper abdominal pain, emesis and weight loss.
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