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PubMed1980

Intra-abdominal abscess caused by Staphylococcus epidermidis.

An immunologically compromised patient was found to have a postoperative intra-abdominal abscess from which Staphylococcus epidermidis was the sole isolate. Studies of the isolate in a rabbit and in mice showed no evidence for unusual virulence of the organism. The S epidermidis probably was introduced into the peritoneal cavity during surgery and, because of the patient's neutropenia, produced a serious infection within a few weeks. To our knowledge, this is the first case of a intra-abdominal abscess associated with S epidermidis to be described in the literature.

Anti-Bacterial Agents↗
PubMed1975

Multinuclide evaluation of hepatic mass lesions.

Radionuclide imaging with labeled colloids is widely used to evaluate and localize primary and metastatic tumors of the liver. The method is fairly sensitive, but the nonspecificity of focal defects remains a significant limitation. Lesions such as cysts and abscesses appear as space occupying areas that are indistinguishable from neoplastic masses. Utilizing a variety of radiopharmaceuticals, one may obtain additional information concerning such lesions. Hepatic blood flow scintiphotography is performed with the Anger camera following the intravenous injection of a high activity, small volume bolus of 99m-Tc pertechnetate. Vascular lesions such as hepatomas or hemangiomas will show increased activity in the lesion which should easily differentiate them from avascular processes such as abscesses, cirrhotic pseudomasses and most metastatic lesions, all of which remain "cold" on these flow studies. If one does not posses a camera, useful blood pool rectilinear scans of these lesions may be obtained with 131-I or 99m-Tc human serum albumin or ionic 113m-In. Additional information concerning the metabolic activity of focal defects on the colloid study is obtained using 75-Se-selenomethionine or 67-Ga. The former is an indicator of active protein metabolism while the latter attaches to lysozymes of metabolically active cells. With either agent, hepatomas show avid uptake, metastatic lesions show variable uptake, and cysts or chronic pseudotumors of cirrhosis show poor uptake. The two agents differ in abscess detection where 75-Se-selenomethionine uptake is poor while 67-Ga concentration generally is intense. 131-I-Rose Bengal occasionally may prove useful in demonstrating impression by an atypically positioned gallbladder or focal dilatation of the biliary tract as a cause of a defect on the colloid scan. Ultrasound examination may complement the radionuclide studies. It is useful for corroborating the presence of lesions and for evaluating their consistency (cystic vs. solid). The information obtained from this multinuclide approach has made scintigraphy examination of the livermore specific. After the completion of this non-invasive series of studies, one generally may venture an intelligent opinion concerning the etiology of the space occupying disease.

Aneurysm↗
PubMed1984

Continual postoperative antibiotic peritoneal lavage in diffuse peritonitis complicating cesarean section.

Nine women treated surgically for diffuse peritonitis complicating cesarean section underwent continual postoperative antibiotic peritoneal lavage as an adjunct to surgery. In all the patients the indication for surgery was failure to respond to standard medical therapy. Seven patients treated with hysterectomy recovered without evidence of continuing peritonitis or intraabdominal abscess formation. One of two patients in whom uterine conservation was attempted required an emergency hysterectomy three days later. In this series, continual postoperative antibiotic peritoneal lavage appeared to be an effective adjunctive treatment in the prevention of continuing peritonitis and abscess formation provided that hysterectomy was performed at the initial operation.

Adult↗
PubMed1997

Intestinal perforation after suction lipoplasty: a case report and review of the literature.

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.

Abdominal Abscess↗
PubMed1981

[Transpleurodiaphragmatic drainage of post-operative sub-phrenic abcesses (author's transl)].

About 19 observations, authors analyse a method for treating post-operative sub-phrenic abscesses: transpleurodiaphragmatic drainage. This study is showing the efficiency of the technic which is a real flattening of the abscess. It is showing as well its inocuosness as mortality and morbidity are none in spite of the field this treatment is used on. On the other hand this method prescribes very definite conditions: the real sub-phrenic abscess must be single and quite localized in postero-lateral position.

Adult↗
PubMed1978

Clinical experience with [111 In] indium chloride scanning in inflammatory diseases.

Forty-eight patients were scanned with 111 In-chloride in an attempt to identify the cause of fever. Fifteen true positive scans, 30 true negatives, and 3 false negatives were found. Of the 15 true positives, 7 cases of abdominal or pelvic abscess, and 8 cases of alcoholic hepatitis were detected. The 3 false negatives included: 1) an abscess in the anterior abdominal wall; 2) an abscess in the right upper quadrant at the site of a necrotic gallbladder; and 3) a tuberculous abscesss of the lumbar spine. Examples from the different categories, pitfalls in interpretation and advantages and disadvantages of scanning with 111In-chloride will be presented. These studies indicate that 111In-chloride is a safe, reliable scanning agent for abscesses below the diaphragm especially in patients who cannot undergo adequate bowel preparation.

Abdomen↗
PubMed1986

[Computerized tomography in the diagnosis of subdiaphragmatic abscess].

Examination of 49 patients suspected of the presence of a suppurative process in the subdiaphragmatic space was performed. The use of computed tomography allowed the author to exclude the subdiaphragmatic abscess in 22 (44.9%) of the patients, in the others the exact localization of the abscess, its size and relationships with the neighbouring organs were determined. Results of the computed tomography were of great importance in choice of the surgical tactics for treatment of the patients.

Abdomen, Acute↗
PubMed1976

[Late sequellae of a splenectomy (author's transl)].

This is the case of a patient who underwent splenectomy after traumatic rupture of the spleen. After the operation, while on parenteral feeding, the patient presented with fever and septicemia during approximately 2 months; no origin to this could be found. Two months after the accident the patient died of perforation of a subdiaphragmatic abscess into the stomach and the lung. The authors discuss the possibilities of coming to an earlier diagnosis. They recognize the necessity of a more aggressive attitude to establish the diagnosis.

Adult↗
PubMed1978

Early appearance of abscess after biliary operation.

Three patients who had an air shadow and fluid levels within seven days after biliary surgery are discussed. In retrospect, this direct evidence of a postoperative abscess was overlooked because of its early appearance and other sources of fever that coexisted.

Aged↗
PubMed1977

Gallium imaging in pediatrics.

Gallium-67 citrate imaging was carried out in 59 children from 3 mo to 20 yr of age. Indications for the study included the search for occult inflammatory disease and the detection and staging of malignant disease. The Ga-67 citrate scan had a 96% reliability in confirming or excluding the site of purulent material as a cause of sepsis, and 76% reliability in detecting malignant disease. Tissue distributions in children differ from those in adults primarily in that the epiphyseal plates, spleen, and thymus may show increased activity normally and in the presence of sepsis. These variations are illustrated as possible sources of incorrect interpretation. "Cold" defects may be seen in sterile collections and avascular masses. Experience in this age group seems sufficiently encouraging to continue the use of gallium-67 citrate for the purposes described.

Adolescent↗
PubMed1991

[Diagnosis and treatment of subdiaphragmatic abscess].

The author analyses the results of examination and operative treatment of 38 patients with subdiaphragmatic abscesses. Their ages ranged from 21 to 65 years. There were 29 males and 9 females. It was established that the diagnosis of subdiaphragmatic abscesses should be based on clinical, laboratory, radiological, and ultrasonic data. The results of treatment of these patients are determined by timely recognition of this complication and the terms of the surgical intervention.

Adult↗
PubMed1981

Splenic abscess in infancy--diagnosis by ultrasonography.

Splenic abscess is a rare entity in children, and definite diagnosis is seldom made before operation. A case of splenic abscess in a high-risk infant is reported. An accurate diagnosis has been made preoperatively by ultrasonography. Characteristic sonographic findings are described.

Heart Defects, Congenital↗