total small bowel infarction

[cathy armstrong]

I have read that an serum pyruvate level,  in suspected bowel infarction  is
a diagnostic indicator of gross infarction that is rarely salvagable. Is
there any case for bowel angiography in combo with elevated pyruvate
levels to treat these cases palliatively?
Cathy A



On Feb 2, 2008 7:26 AM, Nick Macartney <nick at macartney.org> wrote:

> Dead man walking.
> Nick Macartney
>
> > -----Original Message-----
> > From: trauma-list-bounces at trauma.org
> > [mailto:trauma-list-bounces at trauma.org] On Behalf Of caesar ursic
> > Sent: 02 February 2008 00:30
> > To: Trauma &amp, Critical Care mailing list
> > Subject: total small bowel infarction
> >
> > 60 y.o male vasculopath (multiple prior myocardial
> > infarctions, peripheral vascular reconstructions, etc) s/p
> > blunt abdominal trauma and repair of mid small bowel blow-out
> > injury (seatbelt injury).  Did well post-op, discharged home.
> >  Re-presents three weeks later with sudden onset abdominal pain.
> > Re-explored.  Entire small intestine infarcted, from ligament
> > of Treitz to ileocecal valve.
> >
> > Therapeutic options?    Close abdomen, morphine drip, game over
> > or....resect, drain, support, hope he can be nourished
> > parenterally if he makes it to ICU.
> >
> > What's the survival rate for total loss of small bowel in
> > this age group?
> >
> > Cordially, etc.
> >
> > CM Ursic, MD
> > Santa Fe, USA
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