total small bowel infarction

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Dead man walking.
Nick Macartney 

> -----Original Message-----
> From: trauma-list-bounces at trauma.org 
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of caesar ursic
> Sent: 02 February 2008 00:30
> To: Trauma &amp, Critical Care mailing list
> Subject: total small bowel infarction
> 
> 60 y.o male vasculopath (multiple prior myocardial 
> infarctions, peripheral vascular reconstructions, etc) s/p 
> blunt abdominal trauma and repair of mid small bowel blow-out 
> injury (seatbelt injury).  Did well post-op, discharged home. 
>  Re-presents three weeks later with sudden onset abdominal pain.
> Re-explored.  Entire small intestine infarcted, from ligament 
> of Treitz to ileocecal valve.
> 
> Therapeutic options?    Close abdomen, morphine drip, game over
> or....resect, drain, support, hope he can be nourished 
> parenterally if he makes it to ICU.
> 
> What's the survival rate for total loss of small bowel in 
> this age group?
> 
> Cordially, etc.
> 
> CM Ursic, MD
> Santa Fe, USA
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