Doctor Alby Pujaan Hati
Spontaneous Tumor Rupture

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Alby awoke from his sleep as soon as he heard the sound of the vibrations of his cell phone. Alby immediately picked up his phone next to his bedside nightstand while glancing at Devi who was still sound asleep beside him. Yes, now Alby is sleeping together with Devi in one bed since Devi had a nightmare a few days ago and caused Devi not to dare to sleep alone.

Alby looked at Renata's name on his phone screen with a bad feeling. There's no way Renata's gonna call him these nights if nothing happens to Sean. Slowly, Alby got up and decided to get out of the room so as not to wake Devi.

"Hello Ta, what's wrong?" alby asked as soon as he answered Renata's phone.

"By" said Renata.

"What's wrong? Did something happen to Sean?" ask Alby to worry.

"Angiosarcoma Sean had already achieved complications of spontaneous tumor rupture. Even bleeding rupture of the spontaneous tumor has resulted in severe intra-abdominal bleeding* and hemoperitoneum*," Renata explained as she sobbed slowly.

Alby closed his mouth not believing what he was hearing. How could Sean be this bad? As a doctor, Alby knows exactly what Renata told him about Sean's condition.

Spontaneous tumor rupture resulting in severe intra-abdominal bleeding and hemoperitoneum is a possibly fatal complication of hepatic angiosarcoma. Tumor ruptures generally carry a very poor prognosis even when bleeding is stopped with emergency transcathether artery embolization* (TAE), which is not the most common cause, the analysis of four patients showed an average survival of 23 days after the tumor rupture and of course that was bad news for Alby.

What will he tell Devi about Sean's condition? Does Alby have to be honest with Devi? But can Devi accept that reality?

Alby rubbed his face in frustration.

"Sean's life won't be long by," isak Renata from across there.

"You don't talk like that! You're a doctor, you can't despair like that Ta! I'm sure Sean's fine. He won't give up on his angiosarcoma" Alby said.

"Om," call Devi with two teary eyes.

Unbeknownst to Alby, Devi has been standing behind Alby ever since Alby answered Renata's call. Actually when Alby's phone vibrates and the name Renata says, Devi also sees it. Because he had not talked to Renata for a long time, Devi intended to join the chat Alby and Renata also he woke up and followed Alby from behind.

Just as Devi was about to reprimand him, Alby's words made her stop her intentions. Angiosarcoma hearts? His sister-Sean suffered from the disease? Devi doesn't know what angiosarcoma is but once she hears Alby's words at the end, Devi is convinced something bad has happened to her brother.

"Dev, when were you there?" alby was surprised.

"Angiosarcoma heart what is om?" devi asked with both eyes filled with tears.

"Dev please you have to calm down," said Alby as he approached Devi while trying to hold Devi's shoulders but Devi immediately brushed her aside.

Devi reached into her phone and immediately opened her search application. Devi was so surprised to find the information that appeared in her search application.

"Explain to me om!!" devi shouted while crying loudly.

"I'll explain everything to you but you have to be calm" Alby persuaded while calming the hysterically crying Devi to the point of hugging Devi so that the girl was calm and not rebellious.

"Let go of me!! Release!!" yelled Devi while crying loudly and rebelling with all her might but Alby did not intend to let go of his embrace instead Alby further tightened his embrace.

"Why didn't Alby tell me from the beginning?!! Why are you keeping it from me?!!"

After that Devi who was tired of rebelling could only cry sobbing in Alby's arms.

After feeling that Devi had calmed down, Alby also invited Devi to return to the room.

"We go back to the room, right? I promise I'll explain everything to you" asked Alby who was answered with a nod of the head by Devi.

They both walk to Devi's room and sit on the edge of the bed with Devi resting her head on Alby's shoulder.

"In short, liver angiosarcoma is the same as liver cancer."

"Cancer?" repeat Devi's possessed by Alby. Next flows the story from the beginning Sean tells Alby about his illness to the latest condition that Renata has just reported to Alby.

"Why not just a liver transplant? Sean's damaged liver can be replaced with a new one so the cancer can also disappear. Isn't that a good idea? Let's call Renata and tell her to have a liver transplant now!" said Devi while shaking Alby's hand.

"We can't have a liver transplant" Alby said.

"Not."

"Then what?"

"Although previously considered a viable treatment option, liver transplantation is no longer considered for liver angiosarcoma, due to its high recurrence rate and poor post-transplant survival. The European Liver Transplant Registry considers liver angiosarcoma to be an absolute contraindication to liver transplantation, they reported that the average survival after a liver transplant was less than 7 months with no one surviving more than 23 months, showing a very small difference from no treatment at all," alby.

"Isn't that better than 23 days?" devi asked with tears.

"Yes, but not Sean's condition because your brother has experienced spontaneous tumor rupture. Liver transplantation is impossible."

Hearing that made Devi's tears even more rushing down her cheeks. Within 23 days the one who was his only family was about to leave him for ever. Devi had not been able to accept all of this reality.

Why didn't her brother tell her about her illness? Why would Alby also keep the pain Sean was experiencing from her?

Devi suddenly thinks of something, isn't the one who contacted Alby Renata? But how can Renata be with her brother? Do they know each other?

"Renata is your sister's boyfriend" Alby said as if he understood what was inside Devi's head. "Renata deliberately resigned from her job and left for Singapore to accompany and take care of your brother. Forgive Renata for lying to you" continued Alby.

"Sir Renata never lied to me, he just never told me," Devi said in a slightly upset tone.

"I'm sleepy, I'm going to sleep" Devi said as she turned to face Alby.

Alby who saw him just breathed his breath slowly before he joined himself beside Devi.

"Your sister loves you so much she doesn't want to tell you" Alby said, looking at Devi. Alby knew Devi wasn't actually sleeping, proof now that her little back was shaking withstanding the cries. Alby believes Devi is crying right now.

Devi just silently refused to answer Alby's words. Devi knew her brother loved her very much but that was not the reason Devi was angry. Devi is angry that she doesn't know Sean, he knows nothing about Sean and he also feels like a very bad brother to him who every day can only throw tantrums and overwhelm him for nurturing him.

Devi recalls her question to Alby about what kind of person Sean was. Come to think of it, now Devi was very embarrassed. Shouldn't Devi know Sean better than Alby? Devi is his younger sister, but why doesn't he know anything?

"Om tonight I want to sleep alone" said Devi.

Alby sighed softly before he left the room.

"Rest, tomorrow we will go take care of your passport and ask permission to go to your school to go to Singapore with your brother. If you can't sleep, call me, I'll come with you" Alby said, peeping over Devi's head.

After Alby's departure, Devi immediately shed all her tears and cried as she hugged her Totonya doll.

Twenty-three days. Yes, it was the time God gave her brother to enjoy his life. Why just for a minute? Can't her brother keep her company until she's old and has grandchildren? Didn't her brother want to see her become a successful and proud person?

After her parents, will God take her brother? Why did everyone she loved leave her life? What's wrong? Devi does not want anything, Devi only wants her parents and her brother to accompany her to live her life.

After being satisfied crying, fatigue and drowsiness began to be felt by Devi. Devi slowly began to close her eyes and fall asleep in her grief. Devi hopes this is just a nightmare that she used to dream of and after she woke up tomorrow, Devi hopes that the first time she met was her brother Sean who was ironing her school uniform as usual. Yeah, I hope so.

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FYI

Intra/internal bleeding is the loss of blood from blood vessels that collect in the body. Bleeding inside is usually not visible from the outside. It is a serious medical emergency but the severity depends on the degree of bleeding and the location of bleeding (for example head, torso, extremities).

Intra-abdominal bleeding occurs inside the abdomen (abdomen).

Hemoperitoneum (also haemoperitoneum, sometimes also hematoperitoneum) is the presence of blood in the peritoneal cavity.

The peritoneal cavity is the potential space between the parietal peritoneum (the peritoneum that surrounds the abdominal wall) and the visceral peritoneum (the peritoneum that surrounds the internal organs).

Emergency transcathether artery embolization (TAE) is a hemostatic treatment for bleeding or as a treatment for some types of cancer by intentionally clogging blood vessels to starve tumor cells.

Cr. Google

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