Course in the intensive cover unit: The enduring of was admitted at the ICU under the impression of septic bruise probably utility(prenominal) to intraabdominal infection; t/c abdominal compartment syndrome. The plan was to go ventilatory support, start empiric antibiotics, and possible surgery. At this time, the perseverings root pressure dropped further to 94/50 even with fluids. Heart rate was at one hundred forty crush per minute, respiratory rate at 30 breaths per minute, and a spotO2 of 80%. The patient still presented with icteric sclera, bibasal crackles, a dist nullifyed abdomen with inactive bowel sounds. The patient too presented with oliguria. Positive air-pressure was provided for the patient. bit on NPO, the patient was given over Tramadol for the pain and sedated with midazolam drip. A CT scan of the upper abdomen was through revealing: (1) livery ectasia with a gallstone at the distal end of the common bile duct (2) intense pancreatitis with possib le abscess organization (3) a possible obstruction in the right urinary collecting system. Laboratory results already showed: rarified levels of serum amylase and lipase which was at par with the radiograph results. The patient underwent an ERCP cognitive operation with stenting, sphincterotomy and gallstone extraction.
Post-operative care was continued at the ICU. A reverberate chest roentgenogram added the finding of a bilateral pneumonia to the preliminary radiographic impression. Piperacillin-Tazobactam was given for the pneumonia and Fluconazole for the nosocomial infection cultured from the endotracheal resistance aspirate. Since the patient was also in acute respiratory failure, blood gases were serially monitored! . Fluids and electrolytes were correct as necessary to assist the patient in providing for sufficient urine output and be physiologically balanced. Laboratory parameters were apply to guide the clinical management of the pancreatitis, which end on the quaternate hospital day. Anemia was corrected with blood...
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