All-out efforts by a team of surgeons at the Government Medical College, Thiruvananthapuram, has given a fresh lease of life to an indigent 21-year-old boy, Vasal, who had been rushed here from Kozhikode MCH in an ambulance, with an uncontrollable bleed following the rupture of an Arteriovenous malformation (AVM).
Vasal, a final year Electronics student at ITI, is the eldest son of Unnimoyi, an auto driver. He was undergoing a dental procedure when he began bleeding from the site and was referred to the Kozhikode MCH.
Detailed diagnosis revealed that the bleed was due to the rupture of an AVM on the face, inside the lower jaw bone. (AVM is an abnormal connect between veins and arteries that affects the blood circulation in the body).
The bleed could be stopped only by a procedure called endovascular embolisation and surgery to remove the diseased tissue and AVM. The facility is currently available in the public sector only in the Sree Chitra Tirunal Institute for Medical Sciences and Technology and MCH here.
The boy was rushed in an ambulance to MCH here on May 4. The embolisation was done at the SCTIMST, while the high-risk surgery was taken up by the team of doctors led by the Head of Plastic Surgery Ajaya Kumar and Manoj of Oral and Maxillofacial Surgery
“The surgery was high-risk as the tangle of blood vessels involved could be connected to the major carotid artery supplying blood to the brain. The patient could die on the table or suffer hemiplegia. We took all possible precautions, explained the risks to the family, before proceeding,” said Dr. Ajayakumar.
The boy was discharged on May 18. Subsequent review showed the patient to be fine.
“The AVM, in this case, is congenital. A total cure is not possible and there is always the risk of multiple recurrence of the same. He will need to undergo an MR angiogram again in three months,” he said.
