“Puncture immediately otherwise the patient will die”

A few minutes that decided about life and death

Dutchman John Lentink is a normally as calm as a mill-pond.  But yesterday when he burst into Dr Martina John’s doctor’s room, the mill was turning at full speed.  He had just performed an x-ray on a Quechua-Indian.  As the man living in Andahuaylas was gasping desperately for air John Lentink immediately put the ultrasound head on his thorax and saw the reason.  A massive effusion in the pericardium (between the two red arrows) greatly reduced the functioning of the heart in a life-threatening way.  The Covid 19 test was negative.  The x-ray immediately made the diagnosis clear: a Miliary Tuberculosis which had caused this huge accumulation of fluid in the pericardium as an added complication.

If a missionary hospital’s patient’s life is at stake, the Hospital Diospi Suyana’s staff work decisively and speedily.  Within no time the patient was lying on an intensive care bed, the pericardium was disinfected and a local anaesthetic was given.  Skilfully Dr Tielmann guided the puncture needle through the ribs and pierced the outer membrane of the pericardium.  More than one litre of a bloody fluid flowed out and the patient could immediately breathe more easily.  As was to be expected the patient’s oxygen saturation climbed steeply.

This was a case that despite massive breathing problems had absolutely nothing to do with Covid 19.  It is still the case that Tuberculosis is widespread in Peru.  We thank God that it was possible to save this Campesinos’ life.

After the successful operation: vascular surgeon Dr Thomas Tielmann (right), ultrasound expert John Lentink (left) and the relieved patient (centre).
The typical patchy areas caused by a Miliary Tuberculosis can be seen in the x-ray of the lungs.
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