Sundays Esophageal Case

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Ken

I would keep doing that and redo the swallow in 5 days.

Tim
Dr T C Hardcastle
M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU)
ATLS  instructor and DSTC Cape Town Course Director
Intern program Coordinator: Surgery
M.Med (Emergency Medicine) Executive Committee member
Clinical Head (Director): Diana Princess of Wales Trauma Unit
Division of Surgery (General) Room 4064
Department of Surgical Sciences
Tygerberg Hospital / University of Stellenbosch
PO Box 19063
Tygerberg 7505
Western Cape
South Africa
e-mail: tch at sun.ac.za
Cell: +27824681615
Office: +27219389281 or 4911 pager 0302



-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]On Behalf Of kmattox at aol.com
Sent: Tuesday, February 06, 2007 2:28 PM
To: Trauma & Critical Care mailing list
Subject: Re: Sundays Esophageal Case


Almost impreceptiable very tiny leal is at the thoracic inlet.   Pt is asymptomatic with normal wbc and being fed via jejunostomy tube.    

K


Sent via BlackBerry, return via KMattox at aol.com
  

-----Original Message-----
From: Kenneth Rütz <rtz at dadlnet.dk>
Date: Tue, 06 Feb 2007 13:14:00 
To:trauma-list at trauma.org
Subject: Sundays Esophageal Case

Dear List and k

How is the patients condition at this state?
Where is the leak?
-If distal, one could try a coverd wall-stent in order to occlude the 
leak, limit the risk of further contamination, and to resume oral 
feding. NPO means there is still saliva going down, thus a need for 
closure even in spite of oral decontamination...
The stent could removed at a later stage, when the patient is fully 
recovered.

Kenneth Rütz
MD. Ph.D,
Senior Registrar, General Surgery
Svendborg, Denmark.
> Two weeks ago, I presented a case of GSW to innominate artery and  esophagus. 
>  He remained afebrile and with normal WBC.   On Day 10  he was fed and spiked 
> a little fever.  Esophageal swallow showed a LITTLE,  TINY leak, but he was 
> put NPO, a jejunostomy tube inserted and his fever  disappeared.   The 
> ultrasound of the neck showed NO expansion of the  hematoma .   Have NOT done an 
> arteriogram.    
>  
> So we are going to NOT feed him for a couple of weeks and repeat the  
> swallow, feeding him via jejunostomy.  
>  
> k
>   
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