[Clinical aspects and treatment of subdiaphragmatic abscess].
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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.
During the last two years 73 patients with a total number of 84 abdominal abscesses have been investigated by ultrasound. Two thirds of the patients (67%) had postoperative abscesses. Spontaneous abscesses occurred in the remaining 33%. Multiple abscesses occurred in the postoperative group only (7 patients). The overall sensitivity in detecting an abscess was 84%. The sensitivity was much better with spontaneous abscesses (92%) than with postoperative abscesses (80%). One third of the patients have also been investigated by computed tomography. The diagnosis was confirmed either by needle aspiration or by operative drainage. Ultrasound was most useful in detecting abscesses in the right and left upper quadrant and in the pelvis, while CT was superior in the mid-abdomen and when dealing with multiple abscesses.
23 abdominal abscesses were diagnosed by ultrasound and confirmed by sonographically guided puncture. 18 cases were treated by an evacuating needle puncture and 5 cases by sonographically guided percutaneous drainage. In 12 out of 15 patients, fine needle puncture was curative without surgery required (80%). 2 out of 4 patients treated by percutaneous drainage had to be operated. Initially, 4 patients were operated, though after fine needle puncture or drainage a complete remission of symptoms and leukocytosis was observed. There were 2 complications: one hemorrhage leading to death following fine needle puncture of a pancreatic abscess and one temporary septicaemia. Sonographically guided fine needle puncture is simple and effective procedure in treatment of abdominal abscesses and should be considered as an alterative to surgery.
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Abdominal ultrasonography often enables to display the fluid collection of an abcess or haematoma. This type of diagnostic procedure is most useful in a post-operative period. The intestinal gases which stop the ultrasonic beam may be responsible for diagnostic failures. Positive results, which are the most frequent, are never the less precious to assess and decide a treatment policy.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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