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PubMed1999

Prevention of intra-abdominal abscesses and adhesions using a hyaluronic acid solution in a rat peritonitis model.

HYPOTHESIS: Hyaluronic acid (HA)-based bioresorbable membrane and 0.4% HA solution reduce intraabdominal adhesion and abscess formation in a rat peritonitis model. DESIGN: Randomized laboratory experiment. SETTING: A university hospital. INTERVENTIONS: In 72 male Wistar rats, a bacterial peritonitis was induced using the cecal ligation and puncture model. Animals were randomized to receive isotonic sodium chloride solution (group 1), HA-carboxymethylcellulose bioresorbable membrane (group 2), or 0.4% HA solution (group 3). Half of each group were killed at day 7 and half at day 21, and adhesions were scored in a blind fashion. The presence and sizes of intra-abdominal abscesses were noted. Cultures were taken for bacterial analysis. MAIN OUTCOME MEASURES: Intra-abdominal adhesions and abscesses. RESULTS: The median severity of adhesions was significantly lower in group 3 compared with group 1 rats at day 7 (II [range, I-IV] vs IV [range, I-IV], respectively; P=.02) and at day 21 (II [range, I-III vs IV [range, II-IV], respectively; P=.02). There was no significant difference between group 2 and group 1 rats on either day. At day 7, abscesses larger than 2 cm were found in 6 of 12 group 1 rats and in 4 of 12 group 2 rats, but in 0 of 11 group 3 rats (P=.01). At day 21, 0 of 11 group 3 rats had an intra-abdominal abscess, in contrast to 4 (33%) of 12 group 1 rats and 5 (45%) of 11 group 2 rats. All cultures of abscesses revealed polymicrobial flora. CONCLUSION: Adhesion and abscess formation are reduced using a 0.4% HA solution, and not HA-carboxymethylcellulose bioresorbable membrane, in a rat model of generalized bacterial peritonitis.

Abdominal Abscess↗
PubMed1999

[Results of sonographically guided percutaneous catheter drainage of intra-abdominal abscesses in surgery].

The results of a retrospective study concerning percutaneous catheter drainage of 62 intra-abdominal abscesses in 60 patients were demonstrated, including the procedure and complications. For the first access a thin needle was used to perform an aspiration biopsy under sonographic control. We placed a pigtail or van Sonnenberg catheter by Seldinger or trocar technique into the abscesses. The primary success rate of percutaneous drainage was 85 %. Complications occurred in 6.4 % of the cases with a mortality of 0 %. This method is an acceptable alternative to surgery for many patients. Ultrasound-guided percutaneous catheter drainage is the method of choice for uncomplicated abscesses, especially in the critically ill patient.

Abdominal Abscess↗
PubMed1995

Indium-111 leucocyte scintigraphy and ultrasound scanning in the detection of intra-abdominal abscesses in patients without localizing signs.

The clinical records of 45 patients with suspected intra-abdominal sepsis but without localizing abdominal signs were retrospectively reviewed. All had undergone both indium-111 leucocyte scintigraphy and real time ultrasound. Twenty-two of the 45 patients were subsequently shown to have intra-abdominal abscesses. Twenty-one patients were identified correctly by indium-111 scintigraphy (sensitivity 95%) and 10 by ultrasound (US: sensitivity 45%). There were two false positive scintiscans (specificity 91%) but no false positive US scans (specificity 100%). There was no correlation between the peripheral white cell count and the presence of absence of an abscess or the likelihood of obtaining a positive scintiscan result. Because of the excellent specificity ultrasound scanning should remain the initial investigations in this group of critically ill patients with indium-111 scintigraphy being used to clarify the US findings or in US negative patients.

Abdominal Abscess↗
PubMed1982

Detection of abdominal abscesses with gallium-67 citrate: correlative studies with computed tomography.

Undiagnosed abdominal abscess is a medical problem of substantial clinical importance. The high morbidity and mortality associated with this entity demand prompt, accurate diagnosis. The combined use of gallium scintigraphy and computed tomography provides the imaging tools necessary to accomplish this goal. If the suspected pathology cannot be localized, gallium scintigraphy is the initial diagnostic imaging procedure utilized. When antecedent events or clinical symptoms suggest a specific site for the suspected inflammatory collection, computed tomography (CT) is used to evaluate the area. The strengths and weaknesses of gallium scanning and computed tomography are explored in depth, and particular emphasis is given to proper technique and the avoidance of pitfalls. A logical approach to the use of these modalities in tandem is presented.

Abdomen↗
PubMed1997

[Ultrasound-controlled, percutaneous drainage: a safe and simple method for treatment of intra-abdominal abscesses].

Ultrasound-guided percutaneous catheter drainage is useful in the diagnosis and treatment of intra-abdominal abscesses. The indication depends on the localisation and cause of the abscess. Keeping the indications, we treated 62 patients with ultrasound-guided percutaneous catheter drainage and recorded a primary success of 90% and no severe complications such as bleeding or bowel perforation.

Abdominal Abscess↗
PubMed1985

Use of 111In-labeled autologous leukocytes to image an abdominal abscess in a horse.

Indium 111-labeled autologous leukocytes were used to image an abdominal abscess in a horse with a palpable abdominal mass and history of Streptococcus equi infection. A focal area of radioactivity was identified in the location corresponding to the abscess. Imaging of this focal uptake was optimal 48 hours after injection. Similar scans obtained in 2 clinically normal horses revealed no evidence of focal radioactivity in this region. The cell labeling procedure gave acceptable labeling efficiency (87.5%) but an excessive number of damaged WBC, resulting in persistent lung radioactivity on all images. No adverse effects were noted. Radiation measured in the horse and its excreta were well within acceptable limits.

Abdomen↗
PubMed1988

A comparison of the penetration of two quinolones into intra-abdominal abscess.

A low-mortality model of an intra-abdominal abscess in the rat has been used to study the penetration of two quinolone agents into pus. Maximum concentrations in pus after intravenous injections were achieved at four hours (ciprofloxacin: 12.7 +/- 3.69 mg/L, fleroxacin: 2.25 +/- 1.82 mg/L), whereas fleroxacin given orally reached the maximum level at two hours (13.39 +/- 3.13 mg/L). Higher concentrations of fleroxacin were recorded in pus than in serum at each time point up to eight hours after administration, but pus levels of ciprofloxacin only exceeded serum levels after 1.5 hours. These antibiotics appear to have a unique property of high penetration into established abscesses and may have an important therapeutic role in the treatment of patients with multiple interloop abscesses.

Abdomen↗
PubMed1990

Factors influencing the treatment of intra-abdominal abscesses.

Forty-eight consecutive patients with 68 intra-abdominal abscesses who had operative or radiologic attempts at drainage were analyzed. Patients who had radiologic drainage were older and had simple abscesses more often. Simple abscesses were treated successfully in a high percentage of patients using both operation and radiologic drainage. Mortality was higher for patients with complex abscesses, and most of these patients required operative treatment. Successful abscess resolution was eventually achieved in 79 percent of patients.

Abdomen↗
PubMed1976

Detection of upper abdominal abscesses by radionuclide imaging.

An improved means of detecting upper abdominal abscesses using the dual radionuclide subtraction technique was applied to 51 patients. 67Gallium citrate was used in the localization of the lesion and 99Tc-labeled human albumin microspheres and 99Tc sulfur colloid were used for subtracting out the interfering background from normal organ concentrations. The procedure provided the parameter capabilities for localization of the abscesses as well as information on their shape and size. Compared to nonsubtraction Ga procedures, 53% more abscesses were diagnosed using the subtraction technique.

Abdomen↗
PubMedDate not supplied

Jejunal leiomyosarcoma presenting as chronic intra-abdominal abscess.

We report a 35-year-old man with jejunal leiomyosarcoma who presented with chronic intra-abdominal abscess. He underwent drainage of the abscess initially but was re-explored four months later when a mass developed. Total excision of the tumor was done.

Abdominal Abscess↗
PubMed1986

Abdominal abscess drainage under radiologic guidance: causes of failure.

The results of percutaneous drainage of abdominal abscesses in 136 patients are analyzed, revealing a failure rate of 23% (31 patients). The mortality rate was 1.4% (two patients); the rate of serious complications was 5% (seven patients). Failure rate was lowest in critically ill patients having palliative drainage only (12%), emphasizing the importance of immediate drainage to stabilize such patients. The low mortality rate is also attributed to prompt palliative drainage. Technical errors were most commonly responsible for failure of procedures (14%), especially failure to recognize and respond to loculation or subseptation, premature withdrawal of drains (12 patients), and inappropriate approach to the abscess (nine patients). Assignment of patients to a clinical interventional radiology service for the duration of this treatment may greatly facilitate management.

Abdomen↗
PubMed1991

[Patent urachus associated with abdominal abscess: report of a case].

A case of the patent urachus associated with abdominal abscess was reported. A 44-year-old woman was consulted to our clinic with the complaints of bladder irritability and discharge from the navel on October 27, 1987. A fist-sized tumor around the umbilicus was pointed out and the cystography from the umbilicus demonstrated that the contrast medium reached to the urinary bladder. The cystoscopy showed the protruded lesion on the dome of the bladder. The pre-operative diagnosis was patent urachus. She received resection of the urachus on November 11, 1987. The pathological finding was pyogenic granuloma of the urachus due to chronic inflammation.

Abdominal Muscles↗
PubMed1986

Operative vs percutaneous drainage of intra-abdominal abscesses. Comparison of morbidity and mortality.

This retrospective case-controlled study compares the morbidity and mortality of 27 percutaneously drained (PD) abscesses with 27 that were surgically drained (SD). Patients were matched for age, sex, diagnosis, and abscess etiology and location. There was no difference in severity of illness (acute physiology score [APS] = 8.3 vs 10.2), comparable morbidity (29.6% vs 40.7%), or mortality (11.0% vs 7.4%) between PD and SD groups. Duration of drainage was significantly longer in the PD group; however, this is explained in part by the 48% vs 18.5% difference in associated fistulae. Failures of the SD group had a higher mean APS (15) than both failures of the PD group (APS = 9.3) and successes of the SD group (APS = 8.6). All three PD group deaths and half of the SD group deaths were related to ongoing sepsis. Surgical drainage of intra-abdominal abscess is as successful as PD. Percutaneous drainage is reasonable initial treatment for intra-abdominal abscess; however, early assessment of clinical status and frequent reassessment are mandatory to ensure that failures are dealth with early. We present a drainage algorithm.

Abdomen↗
PubMed2003

Treatment of intra-abdominal abscesses caused by Candida albicans with antifungal agents and recombinant murine granulocyte colony-stimulating factor.

The aim of the present study was to assess the influence of immunomodulation of host defense with recombinant murine granulocyte colony-stimulating factor (rmG-CSF) on intra-abdominal abscesses caused by Candida albicans. Mice received prophylaxis or therapy with 1 microg of rmG-CSF/day in the presence or absence of antifungal treatment consisting of amphotericin B (0.75 mg/kg of body weight/day) or fluconazole (50 mg/kg/day). The number of Candida CFU in abscesses was significantly reduced (P<0.05) in mice receiving rmG-CSF prophylaxis (day -1 or day -1 through 2) compared with controls on day 8 of infection. Administration of rmG-CSF therapy alone (for 5 days starting on day 4 of infection) had no influence on the number of Candida CFU in abscesses. Amphotericin B treatment was significantly more effective than fluconazole treatment (3.41 log CFU/abscesses; 95% confidence interval [CI], 3.17 log CFU/abscesses; 3.65 versus 3.90 log CFU/abscesses; 95% CI, 3.66 log CFU/abscesses, 4.16 log CFU/abscesses; P<0.05). Therapeutic administration of rmG-CSF in conjunction with an antifungal agent showed a tendency towards a further reduction of Candida CFU in abscesses than antifungal treatment only. In conclusion, in this experimental model of intra-abdominal Candida abscesses, rmG-CSF administration did not have a detrimental influence on the course of infection. Amphotericin B treatment was most effective, and additional rmG-CSF therapy did not antagonize the effect of antifungal treatment. In contrast, addition of rmG-CSF therapy to antifungal treatment might further enhance the beneficial effect of the antifungal agent.

Abdominal Abscess↗
PubMed1981

Effectiveness of computed tomography in the diagnosis of intra-abdominal abscess: A review of 111 patients.

Computed tomography detected intra-abdominal abscess with 97% accuracy in 111 patients who underwent 135 separate scans. A true negative ratio of 0.98, and a true positive ratio of 0.96 was obtained. Further important findings, unrelated to the presence of abscesses, were detected in 41 of the 135 scans. The information given by computed tomography significantly modified clinical management in over 55% of studies performed.

Abdomen↗
PubMed2006

Hydronephrosis caused by intra-abdominal abscess from cecal perforation by an ingested fish bone.

A patient was treated for hydronephrosis caused by an intra-abdominal abscess arising from cecal perforation by an ingested fish bone. To the authors' knowledge there is no previous report of such ureteral obstruction. Ureteral stenting, drainage of the abscess, and ileocecal resection were performed. Six months of stenting were required to attain ongoing ureteral patency following removal.

Abdominal Abscess↗
PubMed2002

Intra-abdominal abscess caused by Listeria monocytogenes in a patient with acquired hemolytic anemia and thrombocytopenia.

We report a case of an intra-abdominal abscess caused by Listeria monocytogenes in a postoperative patient with Evans syndrome (acquired hemolytic anemia and thrombocytopenia). Focal infections with L. monocytogenes are uncommon but have been reported in immunocompromised patients. A few cases of liver abscess in diabetic patients have also been reported. The present case is significant because of the paucity of previously described focal intra-abdominal infections caused by L. monocytogenes, particularly as a postsplenectomy pathogen.

Abdominal Abscess↗
PubMed1983

Role of surgical and percutaneous drainage in the treatment of abdominal abscesses.

Reviewing our experience with 32 surgically and 13 percutaneously drained abdominal abscesses, we propose the following criteria for computed tomography (CT)-assisted percutaneous drainage: (1) the absence of more than two abscess cavities or loculations; (2) drainage route not traversing bowel, uncontaminated organs, or uncontaminated peritoneal or pleural spaces; (3) the absence of a source of continuous contamination; and (4) the absence of fungi as causative organisms. Of nine abscesses that met these criteria, seven were successfully drained percutaneously. In all abscesses that did not meet the criteria, percutaneous drainage resulted in complications. Of the 32 surgical patients, six would have been candidates for percutaneous drainage according to these criteria. Two of those patients experienced technical complications that might have been prevented by the use of percutaneous drainage. Surgical intervention is the preferred treatment in the majority of patients; however, in properly selected patients, CT-assisted percutaneous drainage is highly successful and can prevent unnecessary morbidity and mortality.

Abdomen↗