a patient in septic shock on high vasopressors due to secondary peritonitis(?diverticular rupture) ,cannot be mobilized to CAT scan as surgeons requested
the ultrasound showed fluid with floating debris and sediment
can the drainage of the peritoneal cavity help to stabilize the patient even temporarily?
Given the gravity of this situation, I agree that any procedure that reduces the toxin load is worth trying. Leaving the catheter in place and irrigating with neomycin solution might also help.The problem is subphrenic collections of infected fluid.
Yes. With the advance in interventional and diagnostic radiology and ICU - Some cases can be treated conservatively: drainage with close monitoring and antibiotic coverage. If the leak seals, the patient can avoid surgery.
HoHowever, in the scenario you mentionned (life threatening) surgery should be firsne for source control. If the patient cannot go to scan this be transfedris not obstacle to surgery - as in pre-scan era, xploration laparotomy was done. However, if the patient is not fit for anaesthesi or
other However-..
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