2024, Vol. 7, Issue 3, Part C

A 54-year-old male, recovering from dengue fever, presented with duodenal perforation and acute inferior wall myocardial infarction (IWMI). He had a history of fever, thrombocytopenia, and was being treated on an outpatient basis for dengue, which was confirmed by a positive Dengue IgM test. Upon admission for severe chest pain, ECG revealed ST segment elevation in leads II, III, and aVF, with elevated troponin I levels. Imaging revealed pneumo-peritoneum and duodenal perforation.

The patient was monitored hemodynamically and managed conservatively with intravenous heparin, antiplatelets, and diuretics. After stabilization, he underwent a laparotomy for duodenal perforation. The Choice of Anaesthesia was General anesthesia with invasive monitoring. The surgery was uneventful, and the patient was extubated and transferred to critical care unit for further observation.

Postoperative management included regional anesthesia for pain control, strict fluid management, and the continuation of anti-platelet therapy. The patient recovered well over 10 days.