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Thursday, November 1, 2012

case: bowel gangrene with sepsis and MODS With acute mesenteric venous ischemia

middle aged female with severe pain in abdomen and metabolic acidosis septic shock....after three days of history
and recent onset DM
CECT : s/o acute smv thrombosis with proximal bowel gangrene with peritonitis...

Surgery: emergency laparotomy and lavage and resection of gangrenous jejunum and single layer anastomosis at Dj flexure...

at the time of surgery Nor adr was at 12ml/hr std dilution, heparin oninfusion 3ml/hr.
dopa 10ml/hr..creat: 3.5   TLC: 34,000  and s. albumin 1.4  hb:6.8 with this BP: 90/50.pulae:160/min..

fortunately patient came out of sepsis slowly...and on the path of goin home finally after 25 days of surgery....