Lucknow: A team of doctors at the Apex Trauma Centre of Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI) has successfully treated a 50-year-old road accident victim suffering from severe pyothorax, a collapsed lung and a large accumulation of thick pus in his chest.
The challenging case involved the removal of nearly 1.2 litres of thick pus from the patient’s chest along with a dense pleural peel that had tightly encased the lung and prevented it from expanding. Doctors performed the complicated procedure using Video-Assisted Thoracoscopic Surgery (VATS), enabling the patient to recover and return home in satisfactory condition.
The patient, Mewalal, a farmer and medical store operator from Sonbhadra, was injured in a motorcycle-car collision on the night of April 8. He initially received treatment at a district hospital. However, his breathing difficulties persisted and his condition subsequently worsened, prompting his admission to the SGPGI Apex Trauma Centre.
Doctors said the case was particularly challenging because the patient had several pre-existing health conditions. He had been suffering from hypertension and diabetes for a prolonged period and had also undergone Percutaneous Transluminal Coronary Angioplasty (PTCA) in 2023 for cardiac disease.
Severe Infection and Collapsed Lung
During evaluation and surgery, doctors found that the patient had developed severe pyothorax, with approximately 1.2 litres of thick pus accumulated inside the chest. A heavy layer of pleural peel had formed over the lung, effectively restricting its movement and leaving the lung completely collapsed.
The complexity of the procedure was further heightened by the patient’s need for single-lung ventilation during surgery. Despite the high-risk nature of the case, the specialist team proceeded with minimally invasive VATS.
Through the thoracoscopic approach, surgeons drained the large quantity of infected material and removed the thick pleural peel constricting the lung. The procedure, known as decortication, enabled the collapsed lung to re-expand.
Following surgery, the patient was kept under close observation in the Intensive Care Unit for two days. As his condition steadily improved, he was shifted to the ward. He was eventually discharged from the hospital on September 14 in satisfactory condition.
Multidisciplinary Team Handles High-Risk Case
The surgical team was led by Dr Amit Kumar Singh, Additional Chief, Apex Trauma Centre, with Dr Aditya Singh and Dr Varun Gupta, Senior Residents, Trauma Surgery, playing key roles in the procedure.
Anaesthesia and critical-care management were handled by Dr Ganpat and Dr Rafat Shamim, Additional Professor, Anaesthesia. The ICU and operating-theatre teams also played an important role in the patient’s post-operative management and recovery.
SGPGI Director Prof R.K. Dhiman congratulated the Trauma Surgery, Anaesthesia, ICU and OT teams for successfully managing the highly complex and high-risk case.
He said the successful treatment demonstrated the institute’s multidisciplinary trauma-care capabilities, specialised surgical expertise and advanced critical-care infrastructure.
The case, involving a severely infected chest, a completely collapsed lung and multiple underlying health conditions, highlights the role of coordinated specialist care in managing complicated trauma-related thoracic conditions and facilitating recovery through advanced minimally invasive surgical techniques.
