THIS EXPERIENCE is recorded to refute the belief that 30 to 40 minutes of closed-chest massage is an adequate trial.1,2 It also refutes the belief that fixed dilated pupils and loss of spontaneous respirations are evidence of irreversible brain damage.
Report of a Case
A 32-year-old white man was treated for ulcerative colitis for 11 years with steroids, sulfonamides, and anticholinergics. Because of multiple, draining perianal fistulae, recurrent rectal hemorrhages, and progressively debilitating fever, a total colectomy was advised.Prior to surgery, the heart, the lungs, and even the abdomen were unremarkable upon examination. A preoperative anemia was corrected by the transfusing of 7 pt of whole blood in six days.An abdominoperineal total colectomy with ileostomy required six hours and 8 pt of blood, but was otherwise uneventful. Four hours after surgery, brisk perineal bleeding dropped the blood pressure to 80/65 mm Hg before a perineal bleeder was