Two Hundred Days of Determination: Restoring Hope for a Patient with Complex Gastrointestinal Obstruction
An elderly man with a nearly 20 year history of hemiplegia was admitted to Beijing United Family Hospital after unsuccessful treatment at several other hospitals. He presented with severe malnutrition caused by three gastrointestinal obstructions involving the esophagus, stomach and colon. His condition was further complicated by deep vein thrombosis requiring long term anticoagulation, severe scoliosis, and herniation of the stomach and colon into the chest with extensive adhesions, making treatment exceptionally challenging.
Under the leadership of Dr. Li Wen, Director of the Digestive Center, the multidisciplinary team developed a staged treatment plan. Endoscopic treatment was first performed to relieve the esophageal stricture, followed by three months of nutritional support, improving the patient’s BMI from 14.5 to 20.7 before surgery. During the operation, extensive intrathoracic adhesions required the surgical team to modify the original plan. A combined endoscopic and laparoscopic minimally invasive approach was used to restore both gastrointestinal passage and bowel function while reducing surgical risk.
Following surgery, the patient developed significant postoperative bleeding related to long term anticoagulation and fragile blood vessels. The hospital rapidly coordinated an emergency second laparoscopic procedure to achieve hemostasis. With continued multidisciplinary care, rehabilitation and nutritional support, the patient gradually recovered.
After more than 200 days of treatment, including five endoscopic procedures, the patient regained the ability to eat normally, his BMI increased from 14 to 24, and he was discharged to reunite with his family. Reviewing the case, an overseas expert described the complexity of the procedure as exceptionally rare even in the United States, highlighting the value of multidisciplinary collaboration and minimally invasive innovation in managing highly complex digestive disorders.