-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: GYN: Pelvic Mass (long--good case) From: R. Daniel Braun, M.D. (rbraun@iunet.iupui.edu) Mon Mar 30 13:33:50 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: R. Daniel Braun, M.D.: "Re: anovulation" Previous message: R. Daniel Braun, M.D.: "Re: Screening for Ovarian Cancer" Maybe in reply to: Garry E. Siegel, M.D.: "GYN: Pelvic Mass (long--good case)" Next in thread: R. Daniel Braun, M.D.: "Re: GYN: Pelvic Mass (long--good case)" Calvin speaks wisely. Once you get in on these ladies, clean them out. Also you have a case of lots of cooks. Is it too many?? I don't know. Not having been there in the OR, I can't make any blanket statement, but unless the patient is in severe shock get the adnexa and the corpus. You will get by 99.9% of the time leaving the cervix. Definitely the flora you are dealing with in these patients is from the intestine. Her ultimate outcome now will rest on her ARDS. I was out of town over the weekend, so I am responding late. Dan -----Original Message----- From: Calvin J. Siegers, MD FACOG <csiegers@hayburn.com> To: Multiple recipients of list <ob-gyn-l@talk.obgyn.net> Date: Monday, March 30, 1998 5:44 AM Subject: Re: GYN: Pelvic Mass (long--good case) >At Sun, 29 Mar 1998, Garry E. Siegel, M.D. wrote: >> >>At Sun, 29 Mar 1998, Calvin J. Siegers, MD FACOG wrote: >>> >>>At Sat, 28 Mar 1998, Garry E. Siegel, M.D. wrote: >>>> > >Garry, >Go with what your "gut" is telling you on this case: you're getting no >help from ID (any coliform-anaerobe combo works) or heme/onc(she needed >whole blood then and probably now) or radiology(can they tell you ARDS v >cardiogenic shock?) or your partner (YOU knew what to do when you were >looking right at it). Does her wedge pressure R/O cardiogenic shock? if >so, she has ARDS and be VERY careful with maintenace fluids and vent >setting--real delicate remaining alveoli. What is her hgb and how much >blood has she gotten? No one cares as much about this patient as you do, >no one knows as much about her disease as you do, so please do not stand >down to your expert consultants.... Recommendation: do NOT take this >women back to the OR unless she has a huge new abscess or hematoma(which >still would be better managed by CT drainage) because if you do she will >not survive. Cal > >-- >Calvin J. Siegers, MD FACOG...private practice, 20 yr veteran, Holland, MI > Next message: R. Daniel Braun, M.D.: "Re: anovulation" Previous message: R. Daniel Braun, M.D.: "Re: Screening for Ovarian Cancer" Maybe in reply to: Garry E. Siegel, M.D.: "GYN: Pelvic Mass (long--good case)" Next in thread: R. Daniel Braun, M.D.: "Re: GYN: Pelvic Mass (long--good case)"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Dec 2 05:23:41 2009

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.