List Archives

Tue Jan 23 03:28:53 GMT 2007

We should do these "formal" quizzes more often.  

It's reassuring (although pathetic) to see that attitude problems with radiology exist as well in large trauma centers.  Reminds me of my residence, finished not so long ago!
Although I now have absolutely no problem having the radiologist at the bedside in my small hospital, I can't believe that an attending surgeon giving a "muscled" call to the resident won't give you the exam you want.

As for flexible endoscopy, it is possible to see the esophagus with very little air pushed by the endoscope, unlike the rest of the digestive track.  If that's all you got... because not that many people do rigid esophagoscopy these days!  But of course esophagogram is gold standard, because criteria of non-op treatment are based on it and not endoscopy!

Waiting for the results...  Does the patient have any fever?

JP Arsenault

----- Original Message ----
From: "KMATTOX at aol.com" <KMATTOX at aol.com>
To: trauma-list at trauma.org
Sent: Monday, January 22, 2007 6:21:52 PM
Subject: Re: Sunday's Case

In a message dated 1/22/2007 4:57:37 P.M. Central Standard Time,  
thoracicsurgpa at msn.com writes:

I'd like  the esophogram Dr. Simon requested yesterday.

Ok.   I will do that.   We did want an  esophagogram.    What we encountered 
was a radiology resident in  the middle of the night who said:

1.    I will not do an esophagogram until I go over the  CT with my staff 
(the staff later said that he could make no heads or tails out  of the esophagus 
based on the CT)

2.    If radiology does an esophagogram, he is going to  use Gastrographin in 
this unintubated  patient

3.    This resident REFUSED to do a BARIUM esophagogram  as requested by the 
Chest Surgery and Chief GS resident.  

Impasse----   HELP ----- Do we need to compromise.   

Since you want an esophagogram,   I need more detail on just how  you are 
going to get it done under the above  attitudes.      

I will let you know in the morning the results of our discussions and tests  
that we did get performed.  

AND THEN THE FUN really begins.  

k
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Sunday's Case