42 YRS male, non diabetic, non smoker, non Hypertensive
presented with sepsis, shock, ARF (urea 91, Creat 2.1), P: 140, BP: 90/60 On inotrops..drowsy,
( p/h/o: pain in abdomen for 2 days and USG at that time s/o free fluid in abdomen (moderate) with non visulization of appendix / ? perforated appendix...and hence operated for open appendectomy, post op patient did well for 2-3 days , started having fever, distension, pain, low out put on POD 3....AND was referred on POD 7 night )
Abdominal drain was draining dirty , purulant fluid, after adequate rehydration, USG Done s/o dilated aperestaltic bowel loops with multiple pockets of collection through out the abdomen (on aspiration which drained feculant material )
ABG: WAS s/o over compensated alkaline pH.
Was taken up for surgery suspecting stump blow out / cecal perforation with peritonitis
OF SURPRISE: It was TOTAL MESENTERIC ISCHEMIA WITH GANGRENE OF SMA region..with 1.5 liter of toxic fluid in abdomen...unfortunately ...we could not do much for the patient....
presented with sepsis, shock, ARF (urea 91, Creat 2.1), P: 140, BP: 90/60 On inotrops..drowsy,
( p/h/o: pain in abdomen for 2 days and USG at that time s/o free fluid in abdomen (moderate) with non visulization of appendix / ? perforated appendix...and hence operated for open appendectomy, post op patient did well for 2-3 days , started having fever, distension, pain, low out put on POD 3....AND was referred on POD 7 night )
Abdominal drain was draining dirty , purulant fluid, after adequate rehydration, USG Done s/o dilated aperestaltic bowel loops with multiple pockets of collection through out the abdomen (on aspiration which drained feculant material )
ABG: WAS s/o over compensated alkaline pH.
Was taken up for surgery suspecting stump blow out / cecal perforation with peritonitis
OF SURPRISE: It was TOTAL MESENTERIC ISCHEMIA WITH GANGRENE OF SMA region..with 1.5 liter of toxic fluid in abdomen...unfortunately ...we could not do much for the patient....
Dr. Keyur Bhatt - Best
Gastro Surgeon
Dr. Keyur Bhatt- Best GI
Surgeon
Dr. Keyur Bhatt - Best
Gastro Surgeon
Dr. Keyur Bhatt- Best GI
Surgeon - Dr Keyur Bhatt - Best Gastro Surgeon
Dr. Keyur Bhatt- Best GI
Surgeon - Dr Keyur Bhatt - Best Gastro Surgeon
Dr Keyur
Bhatt- Best GI Surgeon
