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blunt abdominal trauma (pedestrian vehicle accident) 48 hrs earlier, woman presents with acute abdomen, free bile at laparotomy from duodenal-pancreatic separation, whipple’s procedure performed
Comments
jimmycirugia, January 09, 2009
1´She is live?
2: time of the surgery
3: Care post surgery(explain please ITU, Nutrititon; antibiotics; somatostatin? and more
4. Actually how is the health
5. When discharge of the hospital or clinic
denisallard, GF Jooste hospital Manenberg, January 10, 2009
We operated this case in 2001 in our community ‘township’ hospital Cape town and called Prof J Krige from neighbour hospital, Groote Schuur, hepatobiliary expert, for help.
He decided, because of patient good condition and his expertise, to perform the Whipple’s procedure. It took us around 2.5-3 hours and patient remained intubated for one day in our high care unit, was then transferred to Groote Schuur ICU where she remained another couple of days. She did have the usual complications of bile leak….left the hospital alive and fully functional after a couple of weeks. Am not sure if Prof Krige saw her back after that, as our patients do not always afford the money to come to the hospitals.
He has a total of close to 20 whipple’s for trauma and is our national expert on pancreatic trauma. He does not do ‘hot’ acute trauma surgery and that is up to us trauma surgeons and teams.
He does not farvor somatostatin as far as I know, but early nutrition yes. I will ask him again about his antibiotic policy. Me as the trauma surgeon, I only continue AB’s in case of presence of packs in the abdomen or extrapelvic rectal injuries and bone gunshots. Denis Allard
