Re: What to do?
From: art fougner, md (evsono@pipeline.com)
Tue Apr 18 16:53:01 2006
Kudos el!
art
At Tue, 18 Apr 2006, Dr Eberhard Lisse wrote:
>
>Art,
>
>This was all a red herring, and Joe C coming closest :-)-O
>
>I sat on her for 6 hours or so with close monitoring. Then BP went to
>180/120 and I sectioned her. On entry into abdomen some edematous fluid.
>On closure, two bleeders from the rectus muscle deep under the sheath.
>Neither had bothered me too much. Urine concentrated and haematuric.
>
>They phoned me in the middle of the night because of anuria and no blood
>pressure. On my arrival they had pumped her with Ringers, BP 100/50 PR
>77. She was oriented and didn't really understand what all the fuss was
>about.
>
>So we pushed her into ICU and sorted out the pre-renal failure with iv
>fluid via a CVP and lasix.
>
>Then we sorted out the polyuric renal failure with more fluid.
>
>Applied a serious pressure bandage to the oozing wound and transfused
>her with Packed cells and platelets raising the Hb from 7 to 12 and the
>Platelets from 30 to 80. Oozing stopped eventually but she is having a
>large haematoma in the abdominal skin.
>
>Couldn't really do much about the transaminases in their 3000s.
>Bilirubin wasn't too high though. But we did sort out her hypertension.
>
>After 7 days in ICU she was transferred to the normal ward yesterday and
>gave me a hard time this morning that the ward is cold and she wants to
>go home. Hb remains at 11.3, Urea and creatinine are normal, K is lowish
>being replaced orally. I haven't received the LFT yet, but have pulled
>the CVP out.
>
>Baby 1250g and doing well, by the way.
>
>greetings, el
>
>on 4/18/06 8:13 PM art fougner, md said the following:
>> amylase ... serum and urinary
>>
>> art
>>
>> At Tue, 18 Apr 2006, Dr Eberhard Lisse wrote:
>>> Ultrasound showed a stone in the gall bladder.
>>>
>>> So, what's next?
>>>
>>> el
>>>
>>> on 4/18/06 4:04 PM Joe Cutchin said the following:
>>>> Sono gallbladder. By definition has preeclampsia -earlier seen the worse
>>>> it becomes. Watch closely, I wouldn't send home until pain subsided if
>>>> GB neg. Joe C
>>>>
>>>> Dr Eberhard Lisse wrote:
>>>>> 30 year old G3P2M0 at 28/40 comes in Saturday morning with complaints of
>>>>> severe epigastric pains (after a binge).
>>>>>
>>>>> Clinically nil of note, CTG reassuring, BP 140/90, no edema, 1+ protein
>>>>> in the urine. Hb 13, Platelets 180, Urea, Electrolytes and Uric Acid
>>>>> normal. Transaminases around 30. Bilirubine normal, Clotting Profile
>>>>> norma.
>>>>>
>>>>> What to do next?
>>>>>
>>>>> el
>>>>>
>> --
>> art fougner, md
>> Support Free Speech
>> Buy Danish!
--
art fougner, md
Support Free Speech
Buy Danish!
|
|
