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PubMed1972

[Acute abdomen].

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Abdomen, Acute↗
PubMed1995

Low-velocity gunshot wounds to the spine with an associated transperitoneal injury.

Twenty-nine patients who incurred a transperitoneal low-velocity gunshot wound to their spine were evaluated for the occurrence of spinal infectious complications. All patients underwent an exploratory laparotomy to determine the extent of viscera involvement. No attempt was made to debride the involved spinal area, and the bullet was not removed unless it was easily accessible. Of the 21 patients with a parenchymal and/or noncolonic viscous injury, 17 (77%) were treated with intravenous (i.v.) antibiotics for a minimum of 5 days the remainder received treatment for a maximum of 48 h. All 8 patients with colonic injuries received a minimum of > or = 5 days of antibiotic treatment. Follow-up averaged 44.9 months (range 3-144 months). Only 1 (4.7%) patient with either a noncolonic or parenchymal perforation developed an infectious complication (subdiaphragmatic abscess); two patients (25%) with colonic perforations developed a psoas abscess. No patient developed a spinal infection. This study suggests that patients who sustain a transperitoneal low-velocity gunshot wound to their spine do not need to undergo spinal debridement and may be treated with parenteral antibiotics. Any course of broad-spectrum antibiotics for 5 days appears to minimize infectious complications. Bullet removal and missile tract debridement of the spine is not routinely necessary.

Adolescent↗
PubMed1976

Pleural empyema in association with renal sepsis.

Five cases of pleural empyema in association with perinephric abscess or renal infection are presented. This represents 4 per cent of a series of 122 pleural empyemas, or 30 per cent of empyemas with subdiaphragmatic aetiology. It is suggested that the renal tract should be investigated in all cases of recurrent or non-resolving pleural empyema of uncertain aetiology.

Abscess↗
PubMed1987

[Nonsurgical therapy of abdominal and retroperitoneal abscesses].

From 1976 to March 1987 intraabdominal or retroperitoneal abscesses were confirmed by ultrasound in 40 patients. 13 patients had surgical drainage with zero-mortality. 3 of 27 patients were treated with antibiotics (only systemically). 24 patients were treated by percutaneous catheter drainage or needle aspiration. Elective cholecystectomy was performed later in 3 patients. Nonsurgical treatment was successful in 22/27 cases. 3 patients died despite percutaneous drainage. Failure of percutaneous drainage required surgical intervention in 3 patients. The considerably poorer primary condition of the patients receiving nonsurgical treatment allows no comparison with the surgical group. Advantages of percutaneous drainage and needle aspiration are a high success rate and low mortality. These techniques can be used even in critically ill persons.

Abdomen↗
PubMed1984

[Radiologic diagnosis of intra-abdominal abscesses by stepwise use of imaging procedures].

Plain radiographs of the abdomen in supine and left decubitus position were combined with additional contrast medium examinations, ultrasonography and computed tomography and used for diagnosis in 47 patients with surgically verified abdominal abscesses. Typical abscess signs were analysed to establish the stepwise use of imaging procedures. Diagnosis of an intraperitoneal or retroperitoneal abscess can be made in over 50% of the cases by accurate interpretation of abdominal plain films. If combined with ultrasonography, diagnosis is possible in even almost 90% of the cases. Computed tomography may additionaly show the exact localisation and extension of the lesion and is mainly used in planning further surgical treatment.

Abscess↗
PubMedDate not supplied

Tandem subdiaphragmatic and pleural sequelae due to lost gallstones following cholecystectomy.

We report two similar thoracoabdominal complications we encountered due to retained gallstones after cholecystectomy. These patients had had an open cholecystectomy after a failed laparoscopic attempt, with spillage of gallbladder debris intraoperatively. They were admitted more than 12 months later with subdiaphragmatic abscesses. Attempted computerized axial tomography (CT) guided drainage of these abscesses resulted in these patients developing pleural fluid collections, which required surgical drainage. The patients underwent exploratory laparotomies, and drainage of the subdiaphragmatic abscesses had revealed gallstones within the abscess cavity. A detailed presentation of these cases, with review of current literature and clinicopathologic issues for discussion are described.

Aged↗