[PHISH] Re: PELVIC GSW

[Jean-Pierre Arsenault]

I was taught that the rectal washout/presacral drain thing was something learned from war casualties, where soldiers are constipated (for obvious reasons) and (more importantly) the velocity of bullets is higher than civilian gun trauma; then a ordinary civilian getting a penetrating rectal trauma didn't need routine washout/drainage, just repair and diversion... But as people don't shoot each other a lot where I live, I don't have much experience on this...

JP

----- Message initial ----
De : Ronald Gross <Rgross at harthosp.org>
À : "Trauma & Critical Care mailing list" <trauma-list at trauma.org>
Envoyé le : jeudi 24 mai 2007, 07 h 29 min 50 s
Objet : Re: [PHISH] Re: PELVIC GSW

I guess it still depends on who you read and who you talk to.....

>>> Ronald Simon <Traumamd at nyc.rr.com> 5/23/2007 11:04 PM >>>
I thought rectal washouts were out along with the presacral drain?
ron simon

Ronald Gross wrote:
> Looks to me like a rectal/rectosigmoid wound.  I would explore, do a
> rigid sig in the OR, localize the injury, and do a colostomy and
> hartmanns with rectal washout.
>
> What did you do, and how did he do?
>
> Ron
> Ronald I. Gross, MD, FACS
> Associate Director of Traumatology
> Hartford Hospital
> Chair, ACS CT Committee on Trauma
> 80 Seymour Street
> Hartford, CT  06102
> 860-545-4187 Phone
> 860-545-2006 Fax
> rgross at harthosp.org 
>   
>>>> "Fernando Aguilar" <draguilarrevelo at gmail.com> 05/23/07 7:10 PM
>>>
>>>>         
> I would like to hear your approach to the following case:
> Male, 32, gunshot wound to left lateral inferior flank (see picture
01),
> no
> exit wound, arrive ER 20 min. after injury.  BP: 120/75, P: 90,
SatO2:
> 98%,
> no cristalloids given.
> Abdomen tender in lower quadrants. FAST Neg.  Rectal: normotonic,
feces
> with
> little blood.  Pulses: OK.
> Abdominopelvic x-ray taken (see picture 02)
> CAT Scan shown (pictures 03, 04, 05)
>
> My hospital is a General Hospital and is one of the 3 mayor hospital
at
> my
> country.  We manage all trauma patients.
>
> Dr. Fernando Aguilar
> General Surgeon
> Calderon Guardia General Hospital
> San José, Costa Rica
>
> Confidentiality Notice
>
> This e-mail message, including any attachments, is for the sole use
of
> the intended recipient(s) and may contain confidential or
proprietary
> information which is legally privileged.  Any unauthorized review,
use,
> disclosure, or distribution is prohibited.  If you are not the
intended
> recipient, please promptly contact the sender by reply e-mail and
> destroy all copies of the original message.
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/ 
>
>   
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/

Confidentiality Notice

This e-mail message, including any attachments, is for the sole use of
the intended recipient(s) and may contain confidential or proprietary
information which is legally privileged.  Any unauthorized review, use,
disclosure, or distribution is prohibited.  If you are not the intended
recipient, please promptly contact the sender by reply e-mail and
destroy all copies of the original message.
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/





      Découvrez ce qui fait jaser les gens ! Visitez les groupes de l'heure sur Yahoo! Québec Groupes.
http://cf.groups.yahoo.com/