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What Causes Cellulitis, Low Blood Sugar And Rectal Bleeding?
Question: my dad is 75, he had a coronary artery bypass graft X 5 about 15 years ago. ? He also has DM, SYndrome X . He is in a federal prison won't be out for 2 years .He has been hospitalized 4 times in the last 2 years but I think they have taken good care of him. He has had cellulitis, blood sugar low, rectal bleeding from INR through the roof.He called me yesterday & said they have done 2 xrays and he has a broken sternal wire. They have not given him anymore details or a plan. I would guess he would need a CT to see if its near something vital. If it's moving. What are your thoughts?
Many Thanks,
XXXXXXX XXXX
Many Thanks,
XXXXXXX XXXX
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello,
Welcome and thank you for asking on HCM!
I passed carefully through your dad's medical history and would say that, though rare, CABG sternal wire may break and give several potential complications.
As you rightly suppose, the first step to follow is a careful diagnostic work up, to detect any possible wire migration to the adjacent vital organs (there has been reports of pleural damage and subsequent pneumothorax, also mediastinitis which is a dangerous complication, etc).
In the case of suspicion for wire migration and mediastinitis additional imagine studies, such as chest CT may be necessary.
When facing with sterna wire fracture, the issues to consider are: investigating for instability (dehiscence) which may be a precursor of mediastinitis.
In such case an immediate potent broad spectrum antibiotics therapy (according to microbiological culture result) is necessary.
If sternal mediastinitis and instability is confirmed, reconstructive sternal surgery (including sterna exploration, debridement [excision of nonviable tissues]) is the rationale option.
Otherwise, if no mediastinal infection is present, treatment of sterna instability may be achieved by new innovative techniques (using fixating devices).
At the end, in the case of no confirmed sternal instability, then only a frequent medical observation (by means of imagine tests) may be the first step.
Hope to have been helpful to you!
Fill free to ask me again, in case of any further uncertainties.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello,
Welcome and thank you for asking on HCM!
I passed carefully through your dad's medical history and would say that, though rare, CABG sternal wire may break and give several potential complications.
As you rightly suppose, the first step to follow is a careful diagnostic work up, to detect any possible wire migration to the adjacent vital organs (there has been reports of pleural damage and subsequent pneumothorax, also mediastinitis which is a dangerous complication, etc).
In the case of suspicion for wire migration and mediastinitis additional imagine studies, such as chest CT may be necessary.
When facing with sterna wire fracture, the issues to consider are: investigating for instability (dehiscence) which may be a precursor of mediastinitis.
In such case an immediate potent broad spectrum antibiotics therapy (according to microbiological culture result) is necessary.
If sternal mediastinitis and instability is confirmed, reconstructive sternal surgery (including sterna exploration, debridement [excision of nonviable tissues]) is the rationale option.
Otherwise, if no mediastinal infection is present, treatment of sterna instability may be achieved by new innovative techniques (using fixating devices).
At the end, in the case of no confirmed sternal instability, then only a frequent medical observation (by means of imagine tests) may be the first step.
Hope to have been helpful to you!
Fill free to ask me again, in case of any further uncertainties.
Kind regards,
Dr. Iliri
Note: click here to Consult a cardiac surgeon online. to know the best treatment option for your heart-related issues
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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