Urgent Dialysis Indication For Patients With Septic Shock, Ischemic Colitis And Chronic Kidney Disease Undergoing Hartmann’S Procedure
We present a case of a 76-year-old male with a history of chronic kidney disease, diabetes mellitus, hypertension, small bowel resection who arrived at the ED with syncopal episode, generalized fatigue, hypotension and left-sided abdominal pain. Given his leukocytosis, lactic acidosis, acute renal failure and a CT scan concerning for ischemic colitis and septic shock, he underwent emergency sigmoidectomy with end colostomy. His postoperative course was complicated by acute on chronic kidney injury, anemia secondary to persistent bleeding from ostomy. We discuss the indication for urgent dialysis and anesthetic optimization strategies for patients undergoing long operations such as Hartmann’s procedure.
Pham L, Fowler J, Soto R. Urgent dialysis indication for patients with septic shock, ischemic colitis and chronic kidney disease undergoing Hartmann’s procedure. Presented at: American Society of Anesthesiology Annual Meeting; 2022 Oct 21-25; New Orleans, LA.
American Society of Anesthesiology Annual Meeting, New Orleans, LA, October 21-25, 2022.