total small bowel infarction

• Previous message: Ref:Total Small Bowel Infarction
• Next message: trauma-list Digest, Vol 56, Issue 4
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]

When reading below understand that my approach is predicated on the availability of particular premium resource at my institution (namely Kareem Abu-Elmagd).

1.  Resect enbloc and temporary closure
2.  Second look, resect more if necessary, third look if necessary then create end ostomies
3.  TPN
4.  Multivisceral transplant when stable.

We have had a successful outcome using that algorithm with just the patient you described.  

Ben Reynolds, PA-C
Pittsburgh, PA

----- Original Message ----
From: caesar ursic <cmursic at gmail.com>
To: "Trauma &, Critical Care mailing list" <trauma-list at trauma.org>
Sent: Friday, February 1, 2008 7:30:03 PM
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
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/

• Previous message: Ref:Total Small Bowel Infarction
• Next message: trauma-list Digest, Vol 56, Issue 4
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]