A new interesting case for you...

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Hi Ron,

I saw your e-mail on the trauma thing, but I don't need to talk about=20
that...Just want to know if you would like to attend a dinner for=20
Stahl and Ivatury May 18 (Saturday). Ask Rohman too.

Val Katz says hi,

Soula



------------------ Reply Separator --------------------
Originally From: Ronald Simon <Traumamd@nyc.rr.com>
Subject: Re: A new interesting case for you...
Date: 03/28/2002 00:11am


Chest tube on Right, think hard about one on the left. ECHO the heart=20
and off to the OR for a Lap +/- a t-cotomy depending on the output of=20
the chest tube
Ron Simon
JAcobi MEdical Center
Bronx, NY
PS some will not be happy with a 3 liter resuscitation while standing=20
around.

Marcos Reis wrote:

>     This is a very interesting recent case and I'd like to know the=20
> opinion of the Surgeons of the List. At the end I can send the=20
photos=20
> if anybody wants.
>
>     A 19 years old male patient entered in the ER  last monday (=20
> 2002/03/28 ), in shock, with 2 gunshot wounds  ( 10-20 min before=20
> admission ); one gunshot wound in the LEFT posterior axilar line (=20
9th=20
> intercostal space ) and another gunshot wound in the left upper=20
> abdominal quadrant. No exit wounds . Vital signs: BP 70/30, P 140,=20
RR=20
> 32, GCS 14. The auscultation revealed breath sounds decreased  on=20
the=20
> RIGHT hemithorax and he had abdominal pain. We obtained a  chest=20
film=20
> that demonstrated the bullet in the RIGHT hemithorax and=20
fluid/blood=20
> density  all over the RIGHT side, nothing wrong was seen at the=20
LEFT=20
> hemithorax and there was NO widened mediastinum .  The abdominal=20
film=20
> ( AP ) demonstrated a bullet in the projection of  L4. After rapid=20
> administration of 3000ml of IV fluids ( Ringer ) there was no=20
increase=20
> in his blood pressure and the patient was sent to the operation=20
room.=20
> Clear yellow urine was obtained at the urinary catheter .
>
>     What would you do?
>
> =20
>
>     Marcos Reis,  MD  Trauma Surgeon
>
>     Jo=E3o XXII Hospital - Trauma Center - Belo Horizonte, Brazil=20
>

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