[HSF] Acute abdomen plus unstable LM stenosis

[Prasanna Simha M]

Colonic Ischemia due to mesentric artery stenosis - you can get mesentric
infarcts just like cardiac infarction and the two need not be temporaly
related.
Laparotomy prior to CABG as you will have a big problem on CPB with fluid
etc etc (also pays to look if you have massive gut necrosis when nothing
being done may at times be the therapy.
Prasanna

On Dec 6, 2007 6:21 AM, Donald Ross <donross at bigpond.com> wrote:

> 70yr male with unremarkable past history presented with acute abdomen
> and rest angina. ( WCC 20,000 )
> Urgent cath showed subtotal LM, 90% LAD, normal dominant RCA, good LV
> function.
> Balloon placed and emergent cabg ( opcab rima to LAD and lima to OM.)
> Laparotomy next day revealed dead colon which was successfully
> resected but patient fading fast with septic shock despite
> haemofiltration.
>
> Q1. Cause of dead gut in the absence of AF or infarct?
> Q2. Timing of laparotomy : before, during or sooner after cabg?
> Don
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-- 
Prasanna Simha M