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Review of Pramod Mahajan's Injuries

Mumbai: Bharatiya Janata Party General Secretary, Pramod Mahajan is currently critical after being shot by his brother Pravin on Saturday (22nd April) morning at his residence.// Pramod is currently being ventilated in the Intensive Care Unit of Hinduja Hospital and is said to be critical.

Mr.Mahajan, a known diabetic received four bullets which hit mainly his abdomen and chest. The bullets were fired at close range and went through the liver, shattering its right side; it damaged the head of the pancreas, duodenum, along with inferior vena cava (IVC), diaphragm and small intestine. The injury to the inferior vena cava (IVC) and Liver are likely to be the most troublesome. The inferior vena cava is the main vein in the abdomen carrying blood to the heart.

In the first few hours he was resuscitated and had multiple blood transfusions (almost 24 units it is said). He was taken up for surgery at the hospital and as the injury to the liver was very extensive, pads or packs made of cotton were used to stop the bleeding and were left behind. Apparently the IVC was repaired. Some of the bullets were left in; as it was felt it would be precarious to remove them.

Today apparently he is slightly better but still critical and he was briefly conscious to recognize a few visitors and smiled at his son.

The doctors have used cotton pads to stop the bleeding. The next key decision will be as to when the abdomen should be re-explored to remove the packs.

The chances of his recovery the doctors say are 50:50. However the odds are against Mr.Mahajan’s recovery. What is currently worrying is that his kidneys are not working optimally. If he goes on to require dialysis, he may not stand it because this will require some anticoagulation ( thinning of blood) and this will make the internal bleeding worse as the clots currently that have been formed are preventing further blood loss. He is also on ventilator and being a diabeti c prone to infections. The longer he stays on the ventilator the more the chance s of lung and systemic infections setting in. This can lead to multi-organ failure.

There were reports in the media about a possible transplant surgery on Mr.Mahajan. This is possibly because of the presence of Dr.Mohammed Rela from King’s College, London. He is an Indian from Chennai trained in liver transplant surgery. He is well known for his expertise in the field and in India has closely worked with Global Hospitals, Hyderabad. He is also a well wisher of Indian cadaver transplant programmed and a well wisher of MOHAN (Multi Organ Harvesting Aid Network) Foundation.

The transplant surgery is absolutely ruled out at this stage. Dr.Rela is here possibly due to his ability to be able to handle many complicated surgeries and when Mr.Mahajan is re-explored, the doctors may want his presence. This is likely to be tomorrow as the pads normally are removed after 24 to 48 hrs.
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