Severe Extended Gangrenous bowel
My colleague had a case of 32 years old man came in with acute abdomen and sever sepsis the other day. Case booked as PGU (claimed stable and failed to mention sepsis while booking) by surgical team.
Upon opening up... that's what we got. Most of the bowels are all gangrenous and lots of adhesions. This chap had an appendisectomy done 2 years ago and since then had been seeking A&E and GP's treatment for abdoment pain every now and then.
His wound was left open with abdominal packs and an urobag suture on top of the laparotomy wound then sealed with Tagaderm. (The picture shows the content after we removed the urobag and packs, can still see the sutures around the wound)
We brought him back to OT the next day hoping to resect the gangrenous bowel and closed back the wound. We gave him ASA classification of 5E for the 2nd operation. We had to CPR him on the table and later twice again in the ICU. When I left the hospital it's about 5:30pm and he is still there but we know we are loosing him already. This morning when I went to work his bed was occupied with a new face.
posted by LT @ 9:28 PM
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1 Comments:
You are right Gasman, the 1st time they opened him up it was with a caecum perforation and lots of interloop abcess. The patient was too bad they couldn't have enough time to proceed, the next day when I brought him to OT, we saw extended gangrane of the bowel as well.
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