RESUMEN
A 34-year-old man was admitted to hospital via the accident and emergency department with severe right-sided abdominal pain and raised inflammatory markers. His pain settled with analgaesia and he was discharged with a course of oral co-amoxiclav. He was readmitted to the hospital 7â days later reporting cough and shortness of breath. His chest X-ray showed a raised right hemi-diaphragm, presumed consolidation and a right-sided effusion. As a result, he was treated for pneumonia. Despite antibiotic therapy his C reactive protein remained elevated, prompting an attempt at ultrasound-guided drainage of his effusion. Finding only a small amount of fluid, a CT of the chest was performed, and this showed a subphrenic abscess and free air under the diaphragm. A CT of the abdomen was then carried out, showing a perforated appendix. An emergency laparotomy was performed, the patient's appendix was removed and the abscess drained.
Asunto(s)
Dolor Abdominal/etiología , Apendicectomía , Apendicitis/diagnóstico , Tos/etiología , Neumonía/diagnóstico , Absceso Subfrénico/diagnóstico , Adulto , Apendicectomía/métodos , Apendicitis/diagnóstico por imagen , Apendicitis/cirugía , Errores Diagnósticos , Drenaje/métodos , Humanos , Laparotomía , Masculino , Absceso Subfrénico/patología , Absceso Subfrénico/cirugía , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
A 23-year-old man with post-traumatic hepatic artery pseudo-aneurysm and subphrenic liver abscess was admitted. He underwent coil embolization of hepatic artery pseudo-aneurysm. The pseudo-aneurysm was successfully obstructed and subphrenic liver abscess was controlled. Super-selective trans-catheter coil embolization may represent an effective treatment for hepatic artery pseudo-aneurysm combined with subphrenic liver abscess in the absence of other therapeutic alternatives.
Asunto(s)
Aneurisma Falso/terapia , Embolización Terapéutica , Arteria Hepática/lesiones , Absceso Hepático/terapia , Absceso Subfrénico/terapia , Heridas no Penetrantes/complicaciones , Adulto , Aneurisma Falso/etiología , Aneurisma Falso/patología , Angiografía , Humanos , Hígado/microbiología , Hígado/patología , Absceso Hepático/etiología , Absceso Hepático/patología , Masculino , Bazo/irrigación sanguínea , Bazo/patología , Absceso Subfrénico/etiología , Absceso Subfrénico/patología , Tomografía Computarizada por Rayos XRESUMEN
Fistulous communications between the abdominal and the pleural cavity are rare; they implicate intra-abdominal sepsis. We present a rare case of subphrenic abscess following gastric perforation, which resulted in thoracic empyema. This report emphasises that gastropleural fistulas, although uncommon, should be considered in differential diagnoses of thoracic empyema, especially when there is a longstanding history of peptic ulceration.
Asunto(s)
Empiema Pleural/etiología , Fístula Gástrica/complicaciones , Úlcera Péptica Perforada/complicaciones , Pleura/patología , Úlcera Gástrica/complicaciones , Absceso Subfrénico/etiología , Empiema Pleural/patología , Empiema Pleural/cirugía , Femenino , Fístula Gástrica/patología , Fístula Gástrica/cirugía , Humanos , Persona de Mediana Edad , Úlcera Péptica Perforada/patología , Úlcera Péptica Perforada/cirugía , Pleura/cirugía , Úlcera Gástrica/patología , Úlcera Gástrica/cirugía , Absceso Subfrénico/patología , Absceso Subfrénico/cirugíaRESUMEN
Intrabdominal penetration with intestinal perforation is a relatively uncommon complication after liposuction. Seven cases have been reported in the literature, with a mortality rate > 50%. Here we present a case of a perforated viscus after suction lipoplasty of the abdomen using the tumescent technique. Multiple small-bowel enterotomies were made with the suction cannula. It is our hope that a heightened awareness of this potentially life-threatening complication will promote early and aggressive diagnosis and treatment of liposuction patients who present with gastrointestinal complaints in the early postoperative period.
Asunto(s)
Perforación Intestinal/etiología , Intestino Delgado/lesiones , Complicaciones Intraoperatorias/etiología , Lipectomía/instrumentación , Complicaciones Posoperatorias/etiología , Absceso Abdominal/etiología , Absceso Abdominal/patología , Absceso Abdominal/cirugía , Enterococcus faecalis , Femenino , Infecciones por Bacterias Grampositivas/etiología , Infecciones por Bacterias Grampositivas/patología , Infecciones por Bacterias Grampositivas/cirugía , Humanos , Perforación Intestinal/patología , Perforación Intestinal/cirugía , Intestino Delgado/patología , Intestino Delgado/cirugía , Complicaciones Intraoperatorias/patología , Complicaciones Intraoperatorias/cirugía , Infecciones por Klebsiella/etiología , Infecciones por Klebsiella/patología , Infecciones por Klebsiella/cirugía , Klebsiella pneumoniae , Persona de Mediana Edad , Peritonitis/etiología , Peritonitis/cirugía , Complicaciones Posoperatorias/patología , Complicaciones Posoperatorias/cirugía , Reoperación , Absceso Subfrénico/etiología , Absceso Subfrénico/patología , Absceso Subfrénico/cirugíaRESUMEN
PURPOSE: To control the position of a puncture needle on an access route, which is not parallel to the CT-scan, using control scans not showing start and target points. METHODS: A software tool has been developed. After CT for biopsy planning x/y coordinates and table position of start and target points have to be determined on CT-scans. The software calculates x/y coordinates of the access route for every table position, which must be marked interactively on control scans. The accuracy of the programme was proven experimentally and the method was used in five patients. RESULTS: There was no difference between the calculated and measured access route in the experiment. Four of five patients were punctured successfully using our method. CONCLUSION: Our method is a promising procedure to control a CT-guided caudo-cranial biopsy access route.
Asunto(s)
Biopsia con Aguja/métodos , Tomografía Computarizada por Rayos X/métodos , Humanos , Hígado/patología , Absceso Hepático Amebiano/diagnóstico , Absceso Hepático Amebiano/patología , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/secundario , Modelos Teóricos , Fantasmas de Imagen , Postura , Programas Informáticos , Absceso Subfrénico/diagnóstico , Absceso Subfrénico/patología , Teratocarcinoma/diagnóstico , Teratocarcinoma/patología , Teratocarcinoma/secundarioAsunto(s)
Enterocolitis/patología , Infecciones por Pseudomonas/patología , Enfermedad Aguda , Enfermedades del Ciego/etiología , Enfermedades del Ciego/patología , Niño , Enterocolitis/complicaciones , Femenino , Humanos , Perforación Intestinal/etiología , Perforación Intestinal/patología , Peritonitis/etiología , Peritonitis/patología , Infecciones por Pseudomonas/complicaciones , Absceso Subfrénico/etiología , Absceso Subfrénico/patologíaAsunto(s)
Adenoma de los Conductos Biliares/complicaciones , Neoplasias de los Conductos Biliares/complicaciones , Enfermedades de las Vías Biliares/patología , Encefalopatías/complicaciones , Cirrosis Hepática/complicaciones , Adenoma de los Conductos Biliares/patología , Neoplasias de los Conductos Biliares/patología , Conductos Biliares Intrahepáticos/patología , Encefalopatías/patología , Colangitis/etiología , Humanos , Hígado/patología , Cirrosis Hepática/patología , Masculino , Persona de Mediana Edad , Absceso Subfrénico/etiología , Absceso Subfrénico/patología , SíndromeRESUMEN
Even today subphrenic abscesses constitute a major problem for the surgeons who are at times their involuntary cause. These abscesses are characterised by a high mortality rate and difficulty of treatment. A careful review of the literature and a fortunately modest experience form the basis for an assessment of what has been achieved and what problems still remain with particular reference to new diagnostic and therapeutic techniques.
Asunto(s)
Absceso Subfrénico , Diagnóstico Diferencial , Drenaje , Humanos , Absceso Subfrénico/diagnóstico , Absceso Subfrénico/diagnóstico por imagen , Absceso Subfrénico/patología , Absceso Subfrénico/cirugía , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
A fatal case of cervical cellulitis is described in which mediastinal and subphrenic abscesses formed. Subphrenic abscess formation is a previously unrecorded complication of oro-pharyngeal infection. The anatomical pathways involved in the spread of infection from the neck to the abdomen and the difficulties in obtaining an airway in such a case are discussed.
Asunto(s)
Absceso/etiología , Angina de Ludwig/complicaciones , Enfermedades del Mediastino/etiología , Absceso Subfrénico/etiología , Absceso/patología , Humanos , Angina de Ludwig/patología , Masculino , Enfermedades del Mediastino/patología , Persona de Mediana Edad , Necrosis , Faringe/patología , Absceso Subfrénico/patologíaRESUMEN
Cefminox (CMNX, MT-141) was administered to 7 cases with postoperative infections including subphrenic abscess and wound abscess, and the clinical effect was good in 2 cases, fair in 2, poor in 2 and unknown in 1. A daily dose was 2 g in 7 cases. The maximum total dose and duration were 22 g and 11 days respectively. Side effect which was observed during the test period was 1 case of drug eruption. No abnormal laboratory findings related to this drug were noted.
Asunto(s)
Cefamicinas/uso terapéutico , Infección de la Herida Quirúrgica/tratamiento farmacológico , Adulto , Anciano , Cefamicinas/efectos adversos , Femenino , Humanos , Masculino , Absceso Subfrénico/tratamiento farmacológico , Absceso Subfrénico/patología , Infección de la Herida Quirúrgica/prevención & controlRESUMEN
CT-guided procedures were attempted in 103 patients suspected of having abscesses. CT-guided procedures were performed for diagnostic specimens in 70 patients; they were successful in 30 of 34 sterile collections and 33 of 36 abscesses. In another 33 patients, diagnostic aspiration was performed and percutaneous drainage was attempted; aspirations were successful in 33 of 33 and drainage in 28 of 33 cases. Of the five not drained, four were undrainable because of anatomic extent or high viscosity of the purulent material. The fifth was a necrotic, squamous cell tumor erroneously thought to be an abscess. No complications were encountered. CT-guided procedures are an effective method for obtaining diagnostic specimens in selected patients.