ards, bowel, cardiac, cardio-pulmonary support, care unit, colon, critical care, education, emergency medicine, hemodynamics, ileus, intensive, intensive care medicine, medicine, multiorgan failure, neuro, obstruction, ogilvie, patient care, pediatric, pseudo-obstruction, respiratory failure, surgical i, syndrome, ventilation
J Nates. Case Of The Month: Case 2/2001. The Internet Journal of Emergency and Intensive Care Medicine. 2000 Volume 5 Number 1.
A 44 year-old white male was admitted to the Neuro-ICU of our institution 4 days after a MVA. His only injury was a fracture/dislocation of L4-L5 vertebrae, and no motor deficits were evident after the lesion had been surgically stabilized. The post-operative period was uneventful until the morning of his ICU admission when, he had vomited and aspirated gastric contents. On arrival to the unit he was pale and sweating profusely; he had clear signs of respiratory distress, distended abdomen, hypoactive bowel sounds and abdominal tenderness. Because of his presentation and physical examination, x-rays of chest and abdomen were requested (see below).
What is your diagnosis?
What other tests would you request to confirm your diagnosis?
What is the management of this condition?
If at any point the patient develops signs of perforation or impending perforation, proceeding to operative decompression or resection may be warranted.