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Thu May 24 03:02:55 BST 2007

Looks to me like a rectal/rectosigmoid wound.  I would explore, do a
rigid sig in the OR, localize the injury, and do a colostomy and
hartmanns with rectal washout.

What did you do, and how did he do?

Ron
Ronald I. Gross, MD, FACS
Associate Director of Traumatology
Hartford Hospital
Chair, ACS CT Committee on Trauma
80 Seymour Street
Hartford, CT  06102
860-545-4187 Phone
860-545-2006 Fax
rgross at harthosp.org
>>> "Fernando Aguilar" <draguilarrevelo at gmail.com> 05/23/07 7:10 PM >>>
I would like to hear your approach to the following case:
Male, 32, gunshot wound to left lateral inferior flank (see picture 01),
no
exit wound, arrive ER 20 min. after injury.  BP: 120/75, P: 90, SatO2:
98%,
no cristalloids given.
Abdomen tender in lower quadrants. FAST Neg.  Rectal: normotonic, feces
with
little blood.  Pulses: OK.
Abdominopelvic x-ray taken (see picture 02)
CAT Scan shown (pictures 03, 04, 05)

My hospital is a General Hospital and is one of the 3 mayor hospital at
my
country.  We manage all trauma patients.

Dr. Fernando Aguilar
General Surgeon
Calderon Guardia General Hospital
San José, Costa Rica

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