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    Default a simple retroperitoneal cyst?

    i had an interesting case today, so i thought i'd share..

    28 y.o. female, 5'8" 83kg. NKDA. pertinent medical hx includes overweight (BMI near 28) and asymptomatic GERD (on prilosec).
    past surgical hx (for pancreatic stones) benign. anesthesia hx benign as well.
    asymptomatic hx except for past few days with abdominal pain. no significant labs to note. any relevant enzymes WNL.
    presents with abdominal pain, on morphine PCA for the last day. only using it sparsely. comes down with two 22 g PIVs with K-phos infusing in one, and D5 1/2 NS with K+ in the other. Phos normal, K+ 3.5. other labs WNL.
    speaks poor english. native spanish.
    planned surgery is a retroperitoneal resection of mass, possible chole, possible partial nephrectomy. on CT, mass is apparently close to iliac vessels and right ovary. not sure of depth of involvement.

    for students first...
    plan of care?
    concerns?
    thoughts?
    questions about hx?

    i'll add a twist after some time...
    Last edited by ethernaut; 09-24-2010 at 03:02 AM. Reason: additions and corrections
    i got a BA in graphic arts at a local online community college. GPA was 2.7. got into anesthesia by the grace of jeebus. i'm now the best charter in my department -- ca. 2010

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