Posted on 03/01/2006 3:20:59 AM PST by Born Conservative
NEW YORK, Feb. 28 - Two Republican governors are both recovering in the hospital from complications of gastrointestinal surgery that led to surprisingly lengthy stays.
New York Governor George Pataki had rare complications after surgery for a perforated appendix.
Kentucky Governor Ernie Fletcher developed pancreatitis along with a potentially life-threatening E. coli infection after surgery to remove a gallstone and a diseased gallbladder.
Doctors at St. Joseph East hospital in Lexington said Gov. Fletcher, himself a physician, may be released tomorrow to recuperate at home.
No date has been set for Gov. Pataki's discharge. He told the New York Times in his only public comment on his ordeal that he's also eager to get back to work "but you have to listen to the doctors."
The twin sagas both began about two weeks ago.
Gov. Fletcher was admitted to the hospital on Feb. 12 for removal of a gallstone that was blocking the common bile duct. During the procedure, doctors discovered his gallbladder was badly diseased and he underwent a second procedure a day later to remove it.
The governor was also suffering from pancreatitis, doctors found. According to the National Institutes of Health, acute pancreatitis has several possible causes in adults -- gallstones, biliary disease, and alcohol use are the main ones, as well as viral infection, traumatic injury, pancreatic or common bile duct surgical procedures, and certain medications.
But after the surgery, the governor developed an E. coli infection that led to dangerously high fever and caused the hospital stay to drag on.
Mark Dougherty, M.D., an infectious-diseases specialist, said the E. coli sepsis is now under control, although Gov. Fletcher will remain on intravenous antibiotics for at least two weeks, even after he goes home.
Gov. Fletcher's pancreas remains slightly inflamed, but pancreatic enzymes now are at or near normal, Dr. Dougherty said, and his elevated white-blood-cell count is returning to normal. A pocket of fluid remains near the governor's pancreas, but Dr. Dougherty said his general improvement probably means the fluid is not infected.
A nasal-jejunal feeding tube, implanted last week to bypass the pancreas, was removed yesterday and doctors hope to allow the governor to resume eating solid food soon, although he may remain on liquids for some time even after he leaves hospital, said Joseph Fine, M.D., the physician in charge of the case.
Gov. Pataki's ordeal began on Feb. 16, when he underwent surgery at Hudson Valley Hospital Center in suburban Westchester County for a ruptured appendix. He would ordinarily have been released a few days later, but he developed intestinal adhesions and subsequently intestinal obstruction.
He was transferred last week to New York Presbyterian Hospital at Columbia, where surgeons operated to relieve the blockage in his digestive system laparoscopically.
According to the National Institutes of Health, such postoperative adhesions are only one of the possible causes of mechanical obstruction of the bowels. Others include hernias, gallstones, and tumors.
In cases of mechanical obstruction, high-pitched bowel sounds can be heard at the site of the obstruction. Possible complications include infection, gangrene of the bowel, and perforation of the intestine.
Obstruction of the bowel is not a common sequel to a ruptured appendix, according to doctors not connected with the case. "This is not the usual routine postoperative course after appendicitis," surgeon Matthew Hutter, M.D., of Massachusetts General Hospital in Boston told the New York Times.
However, some patients have a powerful inflammatory response that creates dense adhesions around the small bowel within a few days after the appendectomy. Return to normal bowel function can be prolonged.
An aide to Pataki said yesterday he is making progress. "The governor's doctors have indicated that there has been a slow return of normal digestive function because of the ruptured appendix," said spokesman David Catalfamo.
"The governor is eating small amounts of food but remains on intravenous nutrition, and also on intravenous antibiotics, to reduce the risk of an abscess, which remains a concern," Catalfamo said in a statement.
According to the National Institutes of Health, acute pancreatitis has several possible causes in adults -- gallstones, biliary disease, and alcohol use are the main ones.
"Governor's Alcohol Use In Dispute!"
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