Absent anal wink bulbocavernosus reflexes

Description:Neurosurgeons often have to decide which patients to perform an out of hours MRI scan on if it is available on the basis of a telephone referral. Since many of these patients have chronic back pain, they will usually be on regular codeine at least and will be constipated. Fixed CES fixed for 48 hours can usually wait. It must be stressed that the patient will not complain of urinary retention hence any patient in whom CES is suspected should have at least a post micturition bladder scan or urinary catheter. I also find it useful to ask the patient if they can feel that they are going to pass flatus and if they can stop it. Evolving CES diagnosed from the history is a true surgical emergency and warrants a comprehensive out -of-hours service including MRI and surgery.

Views: 1882 Date: 2018-05-30 Favorited: 5