List Archives

Tue Feb 6 12:44:27 GMT 2007

Is it luck or skill?

Ben Reynolds, PA-C
Pittsburgh, PA

--- kmattox at aol.com wrote:

> 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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