Thus, contrast-enhanced CT should be performed only after a patient has been adequately hydrated. Insertion of a nasogastric tube and removal of gastric fluid and air are helpful if nausea and vomiting persist or ileus is present. Fasting is maintained for 2 wk and possibly 3 to 4 wk. A nasogastric tube usually counteracts vomiting and intestinal ileus. Parenteral H 2 blockers are given.
Retroperitoneal hemorrhage requires transfusions.
Adequacy of fluid replacement and cardiac function should be gauged at least by a central venous pressure line and usually by measurements obtained with a Swan-Ganz catheter. If arterial blood gases reveal hypoxemia, humidified oxygen via mask or nasal prongs should be used. If hypoxemia does not respond, assisted ventilation may be required. Hypocalcemia generally is not treated. If there is renal failure, serum Mg levels should be monitored and IV Mg given cautiously.