RESUMEN
BACKGROUND/AIMS: The aim of the present study is to assess the usefulness of biochemical and bacteriological analysis of the pancreatic fluid obtained at percutaneous drainage of pancreatic pseudocysts and abscesses guided by ultrasound. METHODOLOGY: The study population was comprised of 65 patients, aged 21-79 years: 18 with abscesses and 47 with pseudocysts. In all cases the etiological factor of pancreatic fluid collections was acute pancreatitis. Microbiological (both of aerobic and anaerobic flora), biochemical (including alpha 2-macroglobulin) and cytological analysis of aspirated fluid was performed. Duration of percutaneous drainage in pseudocysts was 10-40 days (mean 18 +/- 12) and in abscesses 21-56 days (mean 32 +/- 19). RESULTS: Complete resolution of pancreatic fluid collections was obtained in 54 (83%) patients, among them in 40 (85.1%) with pseudocysts and in 14 (77.7%) with abscesses, which was confirmed in follow-up ultrasound and/or computed tomography one year after the catheter was removed. Mild complications of this procedure observed in 17 (26.1%) patients were managed without catheter removal. A variety of organisms were cultured from pancreatic fluid, E. coli being the most prevalent. Enterobacter cloacae, staphylococcus aureus, staphylococcus epidermidis, peptococcus saccharolyticus, propionibacterium acnes and bacteroides fragilis were also isolated. Cytologic analysis of the aspirate revealed no atypical cells. The level of alpha 2-macroglobulin in the pancreatic fluid was significantly higher (p < 0.05) in patients with successful pancreatic drainage as compared to the remaining group. CONCLUSION: Percutaneous drainage represents a safe therapeutic method that also provides additional criteria for the management of patients with pancreatic cystic lesions.
Asunto(s)
Drenaje/métodos , Exudados y Transudados/química , Exudados y Transudados/microbiología , Enfermedades Pancreáticas/diagnóstico , Absceso/terapia , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Pancreáticas/microbiología , Enfermedades Pancreáticas/terapia , Seudoquiste Pancreático/diagnóstico , Seudoquiste Pancreático/microbiología , Seudoquiste Pancreático/terapia , Pronóstico , Ultrasonografía , alfa-Macroglobulinas/análisisRESUMEN
In the rats, which were treated with impairing factors such as: malnutrition, cooling down and ischaemia, translocation was studied. Aerobes as well as anaerobes which penetrated beyond the intestine into the mesenterium, liver, spleen and kidneys were sought. Bacteria in peripheral blood were not found. The results show that the type of bacterium undergoing translocation does not depend on the factor impairing "intestinal barrier" and translocation mechanisms are most probably the same for all the bacteria found.
Asunto(s)
Bacterias Aerobias/fisiología , Bacterias Anaerobias/fisiología , Traslocación Bacteriana/fisiología , Intestinos/microbiología , Estrés Fisiológico/fisiopatología , Animales , Bacterias Aerobias/aislamiento & purificación , Bacterias Anaerobias/aislamiento & purificación , Femenino , Hipotermia/fisiopatología , Intestinos/irrigación sanguínea , Isquemia/fisiopatología , Riñón/microbiología , Hígado/microbiología , Masculino , Mesenterio/microbiología , Trastornos Nutricionales/fisiopatología , Ratas , Ratas Wistar , Bazo/microbiologíaRESUMEN
The purpose of the presented study was the assessment of diagnostic and therapeutic efficacy of percutaneous drainage of pancreatic pseudocysts and abscesses, guided by ultrasound (US). The study population comprised 65 patients, aged 21-79 years: in 18 of them pancreatic abscess and in remaining 47--pancreatic pseudocyst were diagnosed. Causes of the fluid accumulation were: acute pancreatitis--in 57, trauma--in 3 and in 5 the specific etiological factor was not found. Ultrasound was performed with Aloka Hellige SSD 280-LS scanner and Braun Melsungen Nephrofix and Cystofix kits were used for drainage. Enzymatic, bacteriologic and cytologic examination of aspirate was performed. Duration of catheter drainage in pseudocysts was 10-40 days (mean 18) and from abscesses--21-56 days (mean 32). A variety of organisms was cultured from pancreatic fluid, Escherichia coli being most prevalent, also Proteus, Staphylococcus, aureus etc were found. Definite cure was obtained in 54 (83%) patients, among them in 40 (85.1%) with pseudocysts and in 14 (77.7%) with abscesses, which was confirmed in control imaging examinations (US and/or CT) after 4-6 months after catheter was removed. In 10 (15.38%) cases surgical intervention appeared necessary--in 7 patients during unsuccessful drainage and in 3--because of late recurrence. One patient died after relaparotomy. Percutaneous drainage is effective in the treatment of pancreatic fluid collections, allowing in most cases avoiding surgical intervention and providing additional diagnostic data.
Asunto(s)
Absceso/diagnóstico por imagen , Enfermedades Pancreáticas/diagnóstico por imagen , Seudoquiste Pancreático/diagnóstico por imagen , Absceso/terapia , Adulto , Anciano , Drenaje , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Pancreáticas/terapia , Seudoquiste Pancreático/terapia , UltrasonografíaRESUMEN
The authors present the results of their research concerning the bacteriostatic or bactericidal function of the secretion of ceruminous glands of the external auditory duct. In accordance with the statements of the other authors, neither bacteriostatic nor bactericidal function of the ear wax was discovered.