(no subject)

[KMATTOX at aol.com]

I personally would NOT close the pylorus on this first  operation.  If I did, 
I would reach through the open stomach and grab  the pyloric ring with a 
Dexon suture (an 0 or 00)    and occlude  it.   
 
k
 
 
In a message dated 5/18/2008 6:46:13 P.M. Central Daylight Time,  
Sise.Mike at scrippshealth.org writes:

Duodenal  injuries - when to interrupt the pylorus and how to do it.

Difficult  duodenal repair for injury to the 4th portion not involving the 
pancreas and  remote to the ampulla. Through and through 45 caliber gunshot 
wound suture  closure but concern for the repair. Vena cava also repaired. 12 
units of  pRBCs, 12 of FFP and, a 12 pack of platelets. Planning a temporary 
abdominal  wall closure. Do you interrupt the pylorus and, if so, how do you do  it.

Mike Sise
San Diego

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