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gastric issue

Errington Thompson errington at erringtonthompson.com
Thu Nov 5 12:11:11 GMT 2009


Gallbladder is normal size on CT and there is no fluid around the
gallbladder. Liver looks good. No inflammatory changes anywhere in the
abdomen. 

Thanks. 

Errington C. Thompson, MD, FACS, FCCM
Trauma/Critical Care
Talk Show Host - WPEK 880 AM
www.whereistheoutrage.net


-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Krin135 at aol.com
Sent: Wednesday, November 04, 2009 10:34 PM
To: trauma-list at trauma.org
Subject: Re: gastric issue

what's his gall bladder status? Does he have anything that might make you  
think of a small perforating ulcer that got wrapped up in the omentum? what 
you  are describing sounds like a traction torsion due to an adhesion. Since

your  patient is a male, Fitz-Hugh Curtis syndrome is unlikely, and there's 
not that  much else up there in a virgin belly....
 
ck
 
 
In a message dated 11/4/2009 21:24:07 Central Standard Time,  
errington at erringtonthompson.com writes:

I have a  60 year old male whose only previous operation was a
mini-thoracotomy for  pacemaker lead placement. For the last 6 - 8 months (3
years after the  pacemaker), the patient has been unable to eat as much as 
he
normally did.  He has lost weight because he can't eat like he should. He 
has
lost about  50 lbs (he is now down to 250lbs). He got an upper GI which 
shows
the  distal portion of his stomach flipped up on top of the proximal  
portion
causing a pseudo-obstruction. The dye does pass thru the stomach  slowly and
into the duodenum. CT of the abd - reveals the same thing.  Nothing else. He
also had a snuff test which was done under flouro which  shows that his left
hemidiaphragm is paralysed. 

Any  thoughts?

Errington C. Thompson, MD, FACS, FCCM
Trauma/Critical  Care
Talk Show Host - WPEK 880  AM
www.whereistheoutrage.net



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