Re: FRI: urinary obstruction
From: Elrod, Darryl G Maj 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL)
Sat Mar 17 08:21:42 2007
Not to my knowledge I didn't.
//SIGNED//
D. Glen Elrod, Maj., USAF, MC
Obstetrician/Gynecologist
Chief of Obstetrics
48 MDOS/SGOBO
RAF Lakenheath, England
Telephone DSN: 314-226-8130
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From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Myer
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Bornstein
Sent: Saturday, March 17, 2007 2:18 PM
To: Multiple recipients of list OB-GYN-L
Subject: Re: FRI: urinary obstruction
Did you put the suprapubic port through the urachus? It is some time
still connected to the bladder and can cause leakage or problems and if
there was an insulation leak on the cautery it could have caused the
problem
Myer
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From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod,
________________________________
Darryl G Maj 48 MDOS/SGOBO
Sent: Saturday, March 17, 2007 10:09 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: FRI: urinary obstruction
The only time I used any was a quick 2-3 seconds of cautery connected to
Marylands to stop a peritoneal edge bleeder. The biopsy site was right
ovarian fossa, close to the uterosacral. I used the suprapubic port and
would have had the uterus anteverted to access the site.
Glen
//SIGNED//
D. Glen Elrod, Maj., USAF, MC
Obstetrician/Gynecologist
Chief of Obstetrics
48 MDOS/SGOBO
RAF Lakenheath, England
Telephone DSN: 314-226-8130
Comm: +44 (0) 1638 52 8130
Notice of Confidentiality
Under the Privacy Act of 1974, you must safeguard all information
reflected on this e-mail and, if applicable, all attachments.
Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI
37-132, AFI 33-219, and PL 93-579"
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intended recipient(s) and may contain confidential and privileged
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From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of R.
________________________________
Daniel Braun
Sent: Saturday, March 17, 2007 1:39 PM
To: Multiple recipients of list OB-GYN-L
Subject: Re: FRI: urinary obstruction
You didn't mention in your orignal post whether or not you used any kind
of power source. i.e. electricity, harmonic, etc.
Dan
On 3/17/07, Elrod, Darryl G Maj 48 MDOS/SGOBO
<Darryl.elrod@lakenheath.af.mil> wrote:
Just a quick followup on this patient I presented earlier this week.
She has been admitted since Monday with a slowly resolving ileus. Her
bladder had been cleared by the cystogram and her foley was draining
nicely. Because of low grade temps and inability to take po despite
regular bowel movements, we got a CT scan. It was read as early
loculated fluid in the pelvis. Because she was clinically stable, we
sat on that for a day and then finally yesterday decided to go back for
another look.
At surgery we found multiple loops of bowel adherent to the anterior
abdominal wall and while trying to pull out clot from the pelvis found
(created) a hole in the bladder. Thankfully, urology was around at the
time. We opened and ultimately found about 1/3 of the posterior wall of
the bladder (when looking from above) with transmural necrosis. We
resected that section as well as a smaller area on the anterior surface
of the bladder, placed a suprapubic, a JP and will see how she does.
Remember, she came in with 2 liters of urine in the bladder without
sensation of needing to void. Could this bladder distention have been
the cause of the necrosis if it had really been a prolonged event? It
seems reasonable to us, but we can't explain why she had retention,
unless it goes back to anesthesia and the retention started within the
first days and went on for 6 before it was clinically recognized.
Interesting case. I'll keep you all updated as we go.
Glen
//SIGNED//
D. Glen Elrod, Maj., USAF, MC
Obstetrician/Gynecologist
Chief of Obstetrics
48 MDOS/SGOBO
RAF Lakenheath, England
Telephone DSN: 314-226-8130
Comm: +44 (0) 1638 52 8130
Notice of Confidentiality
Under the Privacy Act of 1974, you must safeguard all information
reflected on this e-mail and, if applicable, all attachments.
Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI
37-132, AFI 33-219, and PL 93-579"
This e-mail message including any attachments is for the sole use of the
intended recipient(s) and may contain confidential and privileged
information. Any unauthorized review, use, disclosure or distribution is
prohibited. If you are not the intended recipient, please contact the
sender by reply e-mail and destroy all copies of the original message.
Any questions pertaining to disclosure should be directed to the privacy
officer.
________________________________
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
________________________________
RModugno@aol.com
Sent: Friday, March 16, 2007 7:26 PM
To: Multiple recipients of list OB-GYN-L
Subject: Re: FRI: urinary obstruction
In a message dated 3/13/2007 8:13:10 A.M. Eastern Standard Time,
obgyndoc@swbell.net writes:
She had failure of peristalsis and failure of bladder function.
Could be residual anesthesia effect.
True, I blame all problems on anesthesia.! ;+)
Robert Modugno MD MBA FACOG
Sylva, NC
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R. Daniel Braun, MD FACOG(L) CMT
Professor Emeritus
Dept. of Obstetrics and Gynecology
Indiana U. School of Medicine
R. Daniel Braun
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