ICU

It seems like I will be tackling a pretty interesting case tomorrow on my last day. An ICU patient came in today with a complication of a gastrostomy. He had an exploratory surgery of his stomach that somehow went terribly wrong. He has a hx of throat cancer so he already had a PEG tube placed. Somehow the patient perforated his stomach and tore his esophagus while vomiting, so his PEG isn't usable. Now instead of the normal port on his PEG, they somehow attached a tube and it runs out of his stomach, to the outside of his body and then back into his jejunum. I guess that plan was to feed him through that, but since he perforated his stomach, they aren't feeding his gut at all, obviously. He was started on TPN today, but he has a pretty poor prognosis. His stomach contents leaked out into his abdominal cavity and possibly into his lungs. Looking back today I can't even imagine how I would have felt seeing this kind of case when clinicals started, and it makes me realized how far I've come. I'm hoping we can make some appropriate recommendations for the patient tomorrow.