Another unique case of a 34-yesr old engineer, who had multiple episodes of giddiness and mild abdominal pain. Also he was having breathlessness after climbing 5-10 steps of staircase.

He was evaluated and treated in other corporate hospital in Pune but that didn't improve on his symptoms; then he choose to come to our hospital for treatment.

As soon as he came to our hospital, our team of doctors Dr. Amol Bansode, Dr. Ashish Patil, Dr.  Sandeep Kulkarni (Gastroenterologist) evaluated the patient and did basic investigations like sonography and suspected block in veins of liver and largest vein in tummy called inferior vena cava (IVC). The clinical and sonography findings were confirmed by CT scan and then he was immediately referred to our Vascular & Interventional Radiologist Dr. Yadav Munde for further management by minimally invasive endovascular techniques.

Dr. Yadav Munde then performed Percutaneous IVC thrombectomy by using Angiojet device. This device is recently made available in India and used for the first time in Pune at Sahayadri Hospital, Deccan. Our patient was freed from IVC thrombus immediately after the procedure and his symptoms were relieved completely.

Dr. Yadav Munde is Pune's first university fellowship trained Interventional Radiologist (MUHS) and is one of just a handful Interventional Radiologists in INDIA who possess additional qualification in Interventional Radiology.

Few years back the mainstay of treatment of such disease was only medications like anticoagulation and patients had to suffer from sequel of these vein blocks like ascites, portal hypertension, leg pain, swelling, etc. for lifetime. But with the help of latest treatment like Percutaneous Thrombectomy of IVC by Angiojet technique, the clot in IVC could be removed in just half an hour and normal flow could be established immediately, hence avoiding long term ill effects of IVC block.

The advantage of having Angiojet is- it is safe, reliable and helps the interventional radiologist to clear off the clots from blood vessels very efficiently and quickly hence reducing procedure time and radiation to patient and healthcare workers. As patient recovers early from the disease, it helps to reduce hospital stay and its cost.

Thrombosis of the inferior vena cava (IVC) is an under-recognized entity with a variety of clinical presentations. The implications and complexity of IVC thrombosis (IVCT) merit specific attention.

From a global standpoint, IVCT represents a subset of DVT. Virchow recognized and described the factors predisposing a patient to venous thrombosis. The triad of stasis, vessel injury, and hypercoagulability formulated by Virchow remain the foundation for our understanding of the pathophysiology of DVT in general and for IVCT in particular.

As appreciation of the impact of these factors on the patient has improved, therapy has become more directed.

The clinical presentation of IVCT varies, depending on extent and location of the thrombus. Because of the variability in signs and symptoms, using a classification system to describe the clinical features may aid in the diagnosis of this condition.

Thrombophilic screening and evaluation of the clotting and fibrinolytic systems may aid in the diagnosis of IVCT. Contrast venography remains the criterion standard as the optimal diagnostic study for this condition.

Medical management of vena caval thrombosis focuses on anticoagulation and thrombolytic therapy. Endovascular interventions like Percutaneous thrombectomy is treatment of choice in present era.

Surgical management of this condition consists of caval interruption, thrombectomy but is almost absolute now a days.

When To Seek Medical Care for a Blood Clot In the Vein

Call the doctor immediately if a blood clot is suspected.

• Although a deep vein thrombosis may resolve on its own, the life-threatening consequences of a clot reaching the lung, called pulmonary embolism, are severe enough to warrant seeking medical attention immediately
• The doctor may tell the patient to go immediately to a hospital emergency department

If a person has leg pain or swelling with any risk factors, go to a hospital emergency department immediately

Call 108 if you or someone you know with a current deep vein thrombosis, previous deep vein thrombosis, or other DVT/PE risk factor begins having chest pain, shortness of breath, difficulty breathing, fainting, or any other concerning symptom.

A 56-year old man from Baramati was admitted at SSH Deccan in Nov 17 in coma with Liver and Kidney damage.  He was diagnosed with liver disease 2.5 years back and had previously experienced repeated infections, bleeding and episodes of coma. This required frequent hospitalizations costing around 2-3 lakhs per month. He was advised Liver transplant a year back. He and his family met Dr. Vibhute 1 year ago and got registered for Liver Transplant at Sahyadri Hospitals. He was advised Living Donor Liver transplant, though family had decided to wait for cadaveric organ donor and did wait for 6 months. But suddenly, his condition deteriorated, and he had to be admitted at Sahyadri Hospitals in comatose condition. The patient was in coma for 7 days, and his condition kept getting worse. The Liver Team at Sahyadri Hospitals assessed the condition and advised urgent Living donor Liver Transplant for saving his life. In such scenario, his daughter came forward to donate her liver, and immediate liver transplant was done after necessary assessment of recipient and donor.  Post recovery was uneventful, and patient today is doing well. Until the patient re-gained consciousness on second day of Liver Transplant, he wasn't aware that his daughter had donated her liver for him. Today he is a proud parent indeed, but at the same time would advise people suffering from liver disease, to not waste time once proper assessment and advise is given by doctors, as not everyone would be fortunate enough to receive donor as well urgent transplant treatment. With timely and proper intervention, more lives could be saved.

Deciding to go for living donor transplant, preparation of the living related donor, and urgent transplant- all these events happened so fast, that the family said they had complete faith in Sahyadri's Liver Team led by Dr.Vibhute. They said that at one point of time they had given up but it was Dr. Vibhute and his team's strong support due to which their father could be saved.

A 9-year old boy, native of West Bengal, was suffering from Wilson's Disease, a rare inherited disorder that causes copper to accumulate in your liver, brain and other vital organs. Most people with Wilson's disease are diagnosed between the ages of 5 and 35, but it can affect younger and older people, as well. Copper plays a key role in the development of healthy nerves, bones, collagen and the skin pigment melanin. Normally, copper is absorbed from your food, and excess is excreted through a substance produced in your liver (bile). But in people with Wilson's disease, copper isn't eliminated properly and instead accumulates, possibly to a life-threatening level. When diagnosed early, Wilson's disease is treatable, and many people with the disorder live normal lives.

Reference : Mayoclinic.org

In this case, this genetic disease was detected 1 year ago. The family met Dr. Bipin Vibhute last year, and was advised a liver transplant. The family's financial condition was a major limiting factor for this surgery. Sahyadri Hospitals, Dr. Vibhute & team helped the family with the best support possible. Social workers at Sahyadri Hospitals also guided them for exploring various avenues for support. Interestingly, the family showed lot of determination, gathered around 7 lacs from crowd funding and with support from other avenues for their son's surgery. This story shows that financial hurdles can be overcome, with support and best treatment can be provided. Sahyadri Hospitals salutes the fighting spirit of the child as well as his patients, who have successfully fought the disease, and have set an example for many others, giving a strong message that one should not get bogged down by financial hurdles, and with right support one can get access to good treatment and overcome the disease.