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Renal injury - Part 2

trauma-list@trauma.org trauma-list@trauma.org
Sat, 29 Mar 2003 09:05:16 EST 

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In a message dated 3/29/2003 7:38:24 AM Eastern Standard Time, 
karim@trauma.org writes:

> Although no other injuries were apparent went on to full laparotomy - 
> including inspection and exploration of a haematoma around the descending 
> colon.  This revealed a 2cm laceration to the descending colon, which was 
> repaired primarily.  But not before it leaked faecal contents all over the 
> kidney and kidney repair.
>   
> Now what?
> 

You are through!  Clean up the gross contamination as best you can and leave 
a drain as should have been part of the plan anyway--the contamination really 
should not alter your approach beyond cleaning it out.  Certainly your 
antibiotic coverage should remain perioperative only and not be changed by 
this--the existing evidence cannot be clearer on this point.
ERF

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<HTML><FONT FACE=3Darial,helvetica><FONT  SIZE=3D2 FAMILY=3D"SANSSERIF" FACE=
=3D"Arial" LANG=3D"0">In a message dated 3/29/2003 7:38:24 AM Eastern Standa=
rd Time, karim@trauma.org writes:<BR>
<BR>
<BLOCKQUOTE TYPE=3DCITE style=3D"BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT=
: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px"></FONT><FONT  COLOR=3D"#0000ff"=
 style=3D"BACKGROUND-COLOR: #ffffff" SIZE=3D2 FAMILY=3D"SANSSERIF" FACE=3D"A=
rial" LANG=3D"0">Although no other injuries were apparent went on to full la=
parotomy - including inspection and exploration of a haematoma around the de=
scending colon.&nbsp; This revealed a 2cm laceration to the descending colon=
, which was repaired primarily.&nbsp; But not before it leaked faecal conten=
ts all over the kidney and kidney repair.</FONT><FONT  COLOR=3D"#000000" sty=
le=3D"BACKGROUND-COLOR: #ffffff" SIZE=3D3 FAMILY=3D"SANSSERIF" FACE=3D"Arial=
" LANG=3D"0"><BR>
&nbsp; <BR>
</FONT><FONT  COLOR=3D"#0000ff" style=3D"BACKGROUND-COLOR: #ffffff" SIZE=3D2=
 FAMILY=3D"SANSSERIF" FACE=3D"Arial" LANG=3D"0">Now what?</FONT><FONT  COLOR=
=3D"#000000" style=3D"BACKGROUND-COLOR: #ffffff" SIZE=3D3 FAMILY=3D"SANSSERI=
F" FACE=3D"Arial" LANG=3D"0"><BR>
</BLOCKQUOTE><BR>
</FONT><FONT  COLOR=3D"#000000" style=3D"BACKGROUND-COLOR: #ffffff" SIZE=3D2=
 FAMILY=3D"SANSSERIF" FACE=3D"Arial" LANG=3D"0"><BR>
You are through!&nbsp; Clean up the gross contamination as best you can and=20=
leave a drain as should have been part of the plan anyway--the contamination=
 really should not alter your approach beyond cleaning it out.&nbsp; Certain=
ly your antibiotic coverage should remain perioperative only and not be chan=
ged by this--the existing evidence cannot be clearer on this point.<BR>
ERF</FONT></HTML>

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