Fifth Vital [EN]: Chapter 212

212. Blood Exploding Like a Balloon

Time resumed its flow in the operating room, and four hours had passed since the initial removal of the glass shards.

“Ha!”

Tae-kyung, who had maintained the same position for four hours, lifted his head and exhaled a short sigh.

“Okay! It appears all the glass shards within the abdominal cavity have been completely extracted.”

The collection of small glass fragments extracted from Gam Ji-yeon’s abdomen lay accumulated to one side.

“The quantity is truly immense.”

“Oh, you’ve worked incredibly hard, Doctor.”

“Well, it’s not quite over yet. Please provide another ultrasound.”

“Yes.”

“No…”

Tae-kyung frowned, his gaze fixed intently on the black and white monitor displaying the ultrasound. He meticulously examined the small intestine, section by section, and continued.

“That’s causing a direct blockage.”

“Are you referring to that blood vessel?”

“Yes. From what I can see, it appears to be an artery branching off from the mesenteric artery [the artery supplying blood to the small intestine], but there’s a thrombus [blood clot] obstructing it midway.”

“Then, what course of action should we take?”

Choi Mona inquired, her expression grave.

“Um… Do we have a Fogarty balloon catheter [a thin, flexible tube with an inflatable balloon at its tip] available? I requested it be prepared beforehand.”

“Yes, Director. We have it. What French size do you require?”

“5… No, give me a 4. It’s so small; I believe that size will be necessary.”

At Tae-kyung’s instruction, the nurse retrieved a very slender and elongated instrument, carefully tearing open the sterile packaging on the surgical table to avoid contamination, and presented it.

It was a plastic instrument, remarkably thin, designed for insertion into blood vessels. It featured a mechanism where a balloon inflated at the distal end upon air injection at the proximal end.

“Hand me a bulldog clamp [a small, spring-loaded clamp used to temporarily block blood flow in vessels].”

Tae-kyung, receiving the clamp, applied it to the artery at both ends of the thrombus to prevent blood flow. He then released the clamp on the thrombus side.

Normally, a significant amount of blood would have gushed out, but the thrombus prevented any flow.

“Give me the Fogarty, and pre-soak it in heparin.”

Tae-kyung, holding the instrument, carefully inserted it into the blocked artery. He meticulously monitored the ultrasound to ensure no glass shards were displaced during the process.

Fortunately, no abnormalities were detected, so he advanced the instrument further.

‘Crazy. This is truly an extraordinary task.’

Choi Mona, assisting Tae-kyung, repeatedly marveled at his skill in her mind.

Locating and extracting the numerous glass shards embedded within Gam Ji-yeon’s abdomen was no simple feat.

Maintaining focus and identifying both large and small fragments while hunched over for four hours was physically demanding.

Choi Mona was uncertain why this patient had been transferred to their hospital, but she was certain of one thing.

As a doctor, she could confidently say that coming to Tae-kyung was a stroke of good fortune for this patient.

This was because the surgery was complex, extending beyond merely removing the glass shards.

‘Surgery is unequivocally about skill.’

Regardless of the hospital’s size or the quality of its facilities, it was ultimately the surgeon who saved the patient.

Choi Mona, contemplating this while observing the surgery, fixed her gaze on the hand performing the procedure and concentrated on assisting.

“Okay! Give me the syringe.”

When a syringe was connected to the instrument and air was injected, the blood vessel visibly swelled.

Tae-kyung grasped the Fogarty and began to slowly withdraw it.

In this procedure, the balloon fills the space inside the blood vessel, effectively pushing out impurities, including thrombi.

Tae-kyung proceeded slowly to prevent any tearing of the artery.

‘I’m more nervous just watching.’

Choi Mona swallowed hard, aware of the significant risk of the blood vessel rupturing.

The Fogarty balloon, gradually being withdrawn, eventually reached the end, and there was a sensation of something catching again.

“……!”

Tae-kyung carefully exerted a bit more force to pull the Fogarty.

Popping-

“Oh!”

And at that precise moment, as the balloon exited the artery, blood erupted like a bursting balloon.

Shoosh-

Despite being only about 0.3cm in diameter, a substantial amount of blood gushed out with explosive force due to the thrombus blockage.

It sprayed onto the faces of Tae-kyung and Choi Mona.

“Clamp!! Give it to me quickly.”

Tae-kyung swiftly clamped the opened artery with a clamp (forceps) again, halting the intense bleeding.

“I-It’s stopped.”

“Choi, are you alright?”

Tae-kyung, with considerably more blood splashed on his face, inquired.

“Yes, I’m fine.”

This level of bleeding was unprecedented for Choi Mona, far exceeding the usual bleeding from damaged blood vessels.

The medical staff were taken aback by the explosive hemorrhage, but fortunately, the artery appeared undamaged.

“Give me a micro forcep [a forcep approximately 20cm long, with a very fine tip used for handling hair-thin sutures].”

Tae-kyung began suturing the Fogarty entry point between the Bulldogs [instruments used to temporarily block large blood vessels, similar in principle to clothespins].

He meticulously and evenly sutured the minute opening.

The numbers on the operating room clock continued to climb, indicating the considerable time elapsed since the surgery began.

“Doctor, are you alright?”

Ui-jin asked, observing Tae-kyung operating in an uncomfortable position for an extended period.

“I’m fine; the bleeding woke me up.”

While prolonged surgery was undoubtedly tiring, the surge in concentration from the recent bleeding enabled him to swiftly complete the intricate blood vessel suture.

“Whew! There’s no more now.”

“Has all the glass been removed?”

“Yeah. I believe I’ve removed it all. Give me the GI [short for GI stapler, a device that cuts and sutures the small intestine with staples].”

Tae-kyung inserted the end of an instrument about 15cm long, roughly the size of a finger, into one hole in the damaged small intestine and then inserted the instrument into the other hole.

He then manipulated the two instruments to meet, aligning the cut edges of the small intestine in parallel.

As he manipulated the handle of the instrument with a ‘detachment’ sound, the touching small intestine surfaces were cut and the top and bottom of the surfaces were sutured.

The parallel small intestines became one. Then, after checking for bleeding inside, Tae-kyung manipulated the combined small intestine so that it crossed the instrument.

When he pushed and pulled the handle again, the small intestine was cut and the cut surface was sutured with a stapler.

The damaged small intestine was removed and the normal small intestines were connected to each other.

“Okay, now I’m going to irrigate. Give me warm saline [saline heated to a temperature similar to body temperature].”

He carefully washed the inside while meticulously examining for any remaining glass shards.

He proceeded with the washing, confident that no glass remained due to his meticulousness. Afterward, he pushed the small intestine to the side again and sutured it one by one from the back abdominal wall.

He proceeded meticulously so that it would not open again.

Also, hoping that the wounds in the hearts of the patient and their family, who were surprised by the patient’s injured body, would be healed, he continued to suture meticulously, checking layer by layer.

“Give me something to close the fascia [the fibrous tissue that surrounds muscles].”

Now, as the final step, he began to close the abdominal wall.

It was an act that Tae-kyung had done hundreds of times while performing surgery.

It was an important step, but inevitably, the tension that had been building up to some extent was relieved at this time.

“Phew!”

Tae-kyung laughed without realizing it for a moment.

This was because the formalin smell that had been circulating throughout the operating room had disappeared. He didn’t even know that the smell had changed because he was so focused on the surgery.

‘The patient is doing well.’

After feeling the fifth vital sign, this moment when the urgent stage subsided was the best, but it was the first time he felt so good as today.

“But no matter how I think about it, it’s a bit strange.”

“Yes, what are you talking about?”

“What is it?”

“What’s wrong?”

At Tae-kyung’s words, the medical staff in the operating room turned around and asked one by one.

“No, I don’t think the department store has apologized to this patient at all? And I don’t think they’ve contacted us either, have they?”

“Yes, that’s right.”

“Why is that? Usually, the basic thing to do is to find the victim first and apologize unconditionally.”

“That’s right. It seems like they’re people who don’t even have the basics.”

“Dr. Jung is right. They seem to lack the basics and are irresponsible.”

“Choi Mona?”

“Yes, Doctor.”

“Choi, you shouldn’t misunderstand.”

“Yes? I don’t know what you’re talking about all of a sudden.”

“There are many different values these days.”

Tae-kyung continued, suturing the abdominal wall.

“Well, there are many values ​​flooding, from gender equality to rational consumption, labor movements, capital, management, and so on.”

“Yes.”

“Those things can all be important. Of course, they all have meaning. But what I’m saying is that you shouldn’t forget the most basic things than those things. We are human. If you are human, you must value the lives of others. And that should be prioritized over any other value, but this obvious premise is being ignored too much. Very often, too.”

As a doctor, especially as a surgeon performing surgery, he had no choice but to encounter many people who were injured and lost their lives due to unbelievable accidents.

“Are you talking about the department store?”

“That’s right. Well, even if we concede ten times that they may be busy because it hasn’t been long since they opened, the first thing to do is to check if the victim is okay, but this is not it. No matter how important money is, it can’t be more important than life.”

Tae-kyung was feeling relieved that the surgery was over, but he was also feeling bitter about the unfortunate fact.

“Okay! It’s over now. Gam Ji-yeon, of course, refrain from eating and do full monitoring, and let’s take the patient to the intensive care unit.”

“Thank you for your hard work.”

“Yes, thank you for your hard work, Doctor.”

“You especially worked hard today.”

“Okay. Everyone worked hard today.”

Tae-kyung tore off his surgical gown and left the operating room. And he headed straight to the guardian waiting room where his family would be waiting.

“Gam Ji-yeon’s guardian?”

“Yes?”

When Tae-kyung called the guardian, Lee Min-woo and Gam Deok-chan, who had been sitting with anxious expressions, stood up at the same time.

“Is the surgery over? How is my wife?”

“Is my daughter okay?”

“The surgery went well. It took a long time because we had to remove the glass shards in the abdomen one by one. The patient is currently in the recovery room and will be moved to the intensive care unit, and after a few days of observation, she will be moved to a general ward if there are no problems. You must have been very worried.”

“Thank you. Thank you so much, Doctor. Thank you so much for saving my wife……”

The image of Lee Min-woo, who was full of anger and unable to trust anyone when he was first transferred to our hospital, was no longer there.