List Archives

Sat Oct 7 05:05:42 BST 2006

if there is a false aneurysm that is amenable to selective managemnt, then 
put a coil in its parent vessel...then coil the proximal splenic artery to 
complete he procedure

at our institution this patient would have received angio on day of 
admission. with extravasation on angio, a coil would have ended the drama before it 
started

sal

In a message dated 10/6/2006 5:45:56 PM Eastern Standard Time, 
Rgross at harthosp.org writes:
Angio and embolize, not coil.

>>> "Bjorn, Pret" <pbjorn at emh.org> 10/6/2006 12:18 PM >>>
Adult female MVC.  Left rib fx's 10-12, known splenic inj, read as
Grade
I in spite of contrast blush (not intended as the thrust of this
thread).  

The patient was admitted for two nights, stable throughout, and
discharged with her cooperation and enthusiasm.  She was prescribed
house arrest for a week, drastically limited activity, and an office
visit to follow.

As fate would have it, on post-injury day 6 she suffered a sudden
sharp
LUQ pain with what sounds like a brief vagal response.  She reported
immediately to her local ED, where another CT shows both a persistent
blush plus intraperitoneal hemorrhage (second image).  

At the local hospital, vitals were stable (she was in fact
hypertensive
consistent with her medical history) and her labs were unremarkable
(H&H
12 and 35, roughly identical to previous discharge numbers).  She was
admitted to the local hospital for observation, but her counts slipped
overnight (10 & 27), and so she was transferred back to us.  She
arrives
stable and without any major complaints.  Even a little hungry.

Interested in what others would plan for her.  Observe?  Coil?  Both?
Other?

Pret Bjorn, RN

<<FirstImage.jpg>>  <<SecondImage.jpg>> 

List Archives

For your convenience, find the Trauma List Archive Below

NoM Spleen Returns