GOGETA
I'm Dr. GOGETA
Topics: 321
Posts: 2,718
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A 45-year-old man with alcoholic cirrhosis is bleeding from a duodenal ulcer. He has required 6 units of blood over the past 8 hours, and all conservative measures to stop the bleeding, including irrigation with cold saline, IV vasopressin, and endoscopic use of the laser have failed. He is being considered for surgical intervention. Laboratory studies done at the time of admission, when he had received only one unit of blood, showed a bilirubin of 4.5 mg/dL, a prothrombin time of 22 seconds, and a serum albumin of 1.8 g/dL. He was mentally clear when he came in, but has since then developed encephalopathy and is now in a coma. Which of the following best describes his operative risk?
A. Acceptable as he now is
B. Amenable to improvement if he receives vitamin K
C. Amenable to improvement if he is given albumin
D. Prohibitive unless he is dialyzed to normalize his bilirubin
E. Prohibitive regardless of attempts to improve his condition
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As a general rule, the better it felt when you said it, the more trouble it's going to get you into.
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| mikky
Forum Elite
Topics: 15
Posts: 355
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e...not a surgical candidate...
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srama nee ayutham aithe vijayam nee banisa avuthundi
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| Sayulita
Forum Guru
Topics: 105
Posts: 548
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vitamin k
B
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