Dream team pulls the coals out of the fire

The fourth intervention finally remedied the situation

On the operating table is a young man of 21 years. He has been through a lot and hopes that urologist Benjamin Zeier and general surgeon Dr. Lukas Steffen can solve his medical problem. Here is the summary:

David * comes from the province of La Convención of the state of Cusco. He was in perfect health until November 1, 2022. That day, he learned what severe pain was by having a renal colic on his right side. Since he was insured with the state insurance system Essalud, he was treated in Cusco.

CT scan showed a 7 mm stone in the right ureter. They tried to achieve the departure of the foreign body by medication, but unfortunately without success. The pressure caused a kidney calyx to burst and urine to collect behind the kidney. At the hospital in Cusco, an attempt was made to create a fistula to relieve the pressure and drain the urine to the outside. But the surgeon missed the kidney and nearly stabbed the vena cava, the largest vein in the body. So the catheter had to be removed again.

Now they proceeded to open surgery. But the urologist at the out-of-town hospital chose too high an incision. The search for the stone ended without success. It was now explained to the young man that it would be necessary to insert a splint through the urethra and bladder into the ureter. Actually not a bad plan, but they injured the ureter and the splint was not in the kidney, but in the connective tissue behind it. The complication was concealed from the patient and he was simply sent home. “At some point, we’re going to have to do another surgery on you,” the patient was told, dismissing him to his fate. The family is completely destitute and so David appeared with his relatives in the door of Diospi Suyana Hospital.

There was no time to lose. Anesthesiologist Dr. Natascha Lopata gave the anesthesia. Urologist Dr. Benjamin Zeier, Dr. Lukas Steffen and resident Dr. Ivan took action. They managed to locate and remove the stone. Then they sutured the ureter and inserted a splint, which hopefully will allow the ureter to heal without narrowing (stenosis) in the next few months.

Complications can happen at any time at any hospital. Unfortunately, in many state hospitals, the extent of the problem is not explained to patients. If something goes wrong, the patient is often discharged into helplessness without explanation. (* name changed)

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