[HSF] Acute abdomen plus unstable LM stenosis

[Donald Ross]

Hal,
I certainly would have pushed for that if I had suspected a belly  
full of necrotic bowel.
The poor fellow had more angina then abdo pain and in that situation  
it is hard for a cardiac surgeon to resist.
Don
On 06/12/2007, at 4:49 PM, hgrmd at aol.com wrote:

> Don,
> ? Could the patient have had a LM PCI?? That's one of the few  
> situations in which I would be in favor of it.
>
> Hal
>
>
> -----Original Message-----
> From: Donald Ross <donross at bigpond.com>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Thu, 6 Dec 2007 12:21 am
> Subject: Re: [HSF] Acute abdomen plus unstable LM stenosis
>
>
> 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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