pre-gastric bypass egds
average patient in my city is around bmi of mid 30s. Patients coming in for pre-gastric bypass egds routinely encountered have BMIs in 50s and 60s. I think this may be the most dangerous elective procedure we do. No glidescope or anesthesia machine in room. No syringe or alaris pump, manual propofol pushes. Done in a small endo suite far away from the ORs. Despite preoxygenating and running them lighter, using POM NRB, rapid desats are common. Was told by a partner that there was a bad...
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Source: Student Doctor Network - March 15, 2023 Category: Universities & Medical Training Authors: TheLoneWolf Tags: Anesthesiology Source Type: forums
Lumbar pain after bariatric surgery
So this happened to me last week.
I’m on call, In a trauma surgery. Im calles to the PACU as a pt is complaining of pain, screaming actually
I arrive and see this huge guy, 6 3 ft, 380 lbs, who just got a gastric bypass done an hour ago, screaming everytime he moves, his vitals are normal considering the pain he is in. However he refers no pain at all in his abdomen, he refers a 10/10 lumbar pain in radiating to the left leg, my attending was therem we perfomr just bragard and lasague...
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Source: Student Doctor Network - October 31, 2021 Category: Universities & Medical Training Authors: Sleeplessbordernights Tags: Anesthesiology Source Type: forums
Chronic abdominal pain and nausea?
I'm taking care of an outpatient patient: 60y/o woman with chronic abdominal pain with prior history of gastric bypass, appendectomy, incisional hernia repair. Her pain had been previously controlled with oxycodone 10mg a couple times a day, but recently less effective due to emesis. GI is following now, has her on Zofran, Reglan, Promethazine but the nausea is still pretty severe. Patient is cachectic and having trouble with PO intake. Utox is appropriate.
I'm considering a Fentanyl patch...
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Source: Student Doctor Network - September 22, 2021 Category: Universities & Medical Training Authors: CarabinerSD Tags: Pain Medicine Source Type: forums
Non-paying patient?
Strange circumstance but I have a patient seen at my clinic for the past few months due to widespread body pain with fibromyalgia (in hindsight also psych overlay such as h/o trauma, gastric bypass), maintained on low-dose Buprenorphine by another physician whom she's no longer seeing due to insurance changes. She was reasonable for the first few visits with continuation of Buprenorphine. However at the last visit, she requested for increase to Oxycodone 15mg for pain....and I obviously did...
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Source: Student Doctor Network - September 10, 2021 Category: Universities & Medical Training Authors: CarabinerSD Tags: Pain Medicine Source Type: forums
Med Mal: Gastric Bypass Patient in the ED
Case 9: Abdominal Pain – medmalreviewer
Patient comes into the ED a few days after gastric bypass surgery.
Full workup in the ED, surgeon is consulted via phone, discharged home.
Bounces back a few hours later. HR 140s. No repeat labs or CT, no repeat consultation. Discharge home.
Dies a few hours later. (Source: Student Doctor Network)
Source: Student Doctor Network - May 29, 2019 Category: Universities & Medical Training Authors: bbc586 Tags: Emergency Medicine Source Type: forums
CT abdomen IV contrast vs IV & oral contrast
THis is a question I had been wondering about... When do you guys order IV and oral contrast for a abdominal CT scan? In other words, when would you definitely add oral contrast? From what I understand IV contrast is sufficient for things like diverticulitis, colitis. At my shop, IV contrast ONLY is sufficient for the following:
BMI > 20
Age > 25
No history of GI tract altering surgery (e.g. gastric bypass)
No history or suspicion of inflammatory bowel disease
No abdominal or pelvic surgery...
CT abdomen IV contrast vs IV & oral contrast (Source: Student Doctor Network)
Source: Student Doctor Network - May 21, 2017 Category: Universities & Medical Training Authors: woodhorse22 Source Type: forums
Treatment for mini gastric bypass surgery India
The surgeon creates a narrow tube of the stomach and separates the stomach with staples which is remaining. And then the tube is connected to the lower intestine. The hospital excels in delivering World class treatment for mini gastric bypass surgery India via specialised surgeons and technicians having years of experience. (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - August 18, 2015 Category: Cardiology Authors: sunilk Source Type: forums
