Emergency rescue of a patient with hemorrhagic shock caused by superior mesenteric artery rupture:A case report

BACKGROUND Superior mesenteric artery(SMA)injuries rarely occur during blunt abdominal injuries,with an incidence of<1%.The clinical manifestations mainly include abdominal hemorrhage and peritoneal irritation,which progress rapidly and are easily misdiagnosed.Quick and accurate diagnosis and timely effective treatment are greatly significant in managing emergent cases.This report describes emergency rescue by a multidisciplinary team of a patient with hemorrhagic shock caused by SMA rupture.CASE SUMMARY A 55-year-old man with hemorrhagic shock presented with SMA rupture.On admission,he showed extremely unstable vital signs and was unconscious with a laceration on his head,heart rate of 143 beats/min,shallow and fast breathing(frequency>35 beats/min),and blood pressure as low as 20/10 mmHg(1 mmHg=0.133 kPa).Computed tomography revealed abdominal and pelvic hematocele effusion,suggesting active bleeding.The patient was suspected of partial rupture of the distal SMA branch.The patient underwent emergency mesenteric artery ligation,scalp suture,and liver laceration closure.In view of conditions with acute onset,rapid progression,and high bleeding volume,key points of nursing were conducted,including activating emergency protocol,opening of the green channel,and arranging relevant examinations with various medical staff for quick diagnosis.The seamless collaboration of the multidisciplinary team helped shorten the preoperative preparation time.Emergency laparotomy exploration and mesenteric artery ligation were performed to mitigate hemorrhagic shock while establishing efficient venous accesses and closely monitoring the patient’s condition to ensure hemodynamic stability.Strict measures were taken to avoid intraoperative hypothermia and infection.CONCLUSION After 3.5 h of emergency rescue and medical care,bleeding was successfully controlled,and the patient’s condition was stabilized.Subsequently,the patient was transferred to the intensive care unit for continuous monitoring and treatment.On the sixth day,the patient was weaned off the ventilator,extubated,and relocated to a specialized ward.Through diligent medical intervention and attentive nursing,the patient made a full recovery and was discharged on day 22.The follow-up visit confirmed the patient’s successful recovery.

Prof.Ren ZHANG’s experience in acupuncture for neuromyelitis optica spectrum disorders

Prof.Ren ZHANG’s experience in clinical treatment of neuromyelitis optica spectrum disorders(NMOSD)is summarized in this paper.The pathogenesis of this kind of disease is complicated.Prof.Ren ZHANG treats it in both symptoms and root cause.In the acute stage and remission stage,based on the standard application of western medicines,acupuncture should be applied as early as possible and continued.In the acute stage,acupuncture can be an alternative and complementary treatment to reduce the adverse reaction of high dose hormone and shorten the acute course of this disease.In the remission stage,acupuncture can not only improve the visual function of patients,but also helps to retard the deterioration of this disease,reduce the recurrence and disability degree,having a long-term effect.The specific treatment method of Prof.Ren ZHANG emphasizes a combination of acupuncture and acupoint injection,with the extraordinary points as the main acupoints and coordinate with meridian acupoints in application.In the manipulation,it is emphasized deep insertion,penetrating method,and needling sensation to the diseased location.For the treatment course,it is emphasized that early intervention and long-term regular treatment.Here is the summarization of Prof.Ren ZHANG’s experience in treating this disease,which can be the reference for clinicians.