Re: TOA and HIV

From: DoctorJoe@aol.com
Fri Mar 26 12:46:33 2004


In a message dated 3/26/04 10:31:16, ainsron@sbcglobal.net writes:

> She
> is now still symptomatic with pelvic pain, decreased abdominal
> tenderness, afebrile, WBC has come down from 26,000 on admission with a
> marked left shift, now 14,400 with no bands.  Where would you go from
> here?
> 1- ultrasound or CT guided drainage of the mass
> 2- OR for vaginal drainage of mass / colpotomy
> 3- OR for Abdominal drainage of mass
> 4- OR for TAH/BSO
>
> My feeling is that she is clinically stable enough at this time for
> definitive surgical treatment and to approach it abdominally with plans
> to back off and simply drain it if there is too much phlegmon to safely
> remove it.
>

Why not keep treating, since she is responding, and see how small it can get before you decide to intervene? How's her HIV status (CD4, etc.)?

Joe P.





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