Le: No, I feel [it] in here.
Matthews: Well, get down there and take a look. You’ve got to get your retractor in there – you’ve got to pull up for them, OK? You’ve got to be strong enough to do that. Are you strong enough to do this? OK, get it in there. You’ve got to get a good look at that pancreatic tail. What Dr. O’Neill is trying to say is that he has systemic inflammatory response. You have got to get in there and you have got to take a look. Do you need another set of hands to look down in there? To help pull that bowel back? OK. What I want you to do is get on his side. What you are going to do is reach in there and pull back all that bowel, OK? Le Le, position his hands, get his hands in there. That’s it. Look at his nice white gloves. OK, now pull that down.
Le: Can you give me the Yankaur [suction set]?
Matthews: You need a Yankaur suction. What do you see? Look at that. See all that blood down there? OK, did you wash that out?
Le: Not yet.
Matthews: OK, suck that out [loud gurgling suction noises]. How does the end of that look?
Le: There’s no inflammatory run right here.
Matthews: Yeah, there’s no inflammatory tissue and there is no leaking pancreatic juice down there.
O’Neill: I would strongly recommend that you look in there and that you mend the legical binding, putting suture layers because that could completely avulse—
Matthews: OK.
O’Neill: There’s pre-flaring—
Matthews: Do we have the CT scan to see what this looks like?
O’Neill: Yeah. He went down from the OR.
Matthews: Do you want a drain in there?
O’Neill: Well, that’s what I’m trying to figure out. If it is an aesthetic or if he avulsed the spleen…
Matthews: Sure.
Le: I don’t see anything, though.
O’Neill: But I don’t see anything. I think the surge is related to the blood that he lost.
Matthews: Now did he have—
Le: A post-op hemoglobin level? 20.
Matthews: Post-op hemoglobin at 20? Now I’m looking at this diaphragm and it looks like it is kind of bulging out at us. Do we have a chest tube in on that side?
O’Neill: No he doesn’t. But we might need—
Matthews: Is that, is that bulging out at you?
Le: Yes.