-
Nederlands Tijdschrift Voor Geneeskunde 2017Splenic abscess is a rare and potentially lethal clinical condition. The most common symptoms of a splenic abscess - abdominal pain, nausea and fever - are non-specific.... (Review)
Review
Splenic abscess is a rare and potentially lethal clinical condition. The most common symptoms of a splenic abscess - abdominal pain, nausea and fever - are non-specific. As a result, a splenic abscess is often not considered in the initial work-up. This might lead to a delay in diagnosis and treatment. In this case series we successively describe a 41-year-old female with a splenic abscess after Streptococcus milleri bacteraemia, a 78-year-old male with a splenic abscess caused by a colon carcinoma and a 52-year-old male with a splenic abscess resulting from a colosplenic fistula after bariatric surgery. By emphasizing the different aetiologies, the different clinical presentations and the different therapeutic options of a splenic abscess, we aim to create greater awareness of this rare clinical phenomenon.
Topics: Abdominal Abscess; Adult; Aged; Colonic Neoplasms; Diagnosis, Differential; Female; Fistula; Humans; Male; Middle Aged; Splenic Diseases
PubMed: 29125082
DOI: No ID Found -
Gastroenterology Feb 2021
Topics: Abdominal Abscess; Abdominal Pain; Aged; Cholangiopancreatography, Magnetic Resonance; Cholecystectomy, Laparoscopic; Female; Gallstones; Humans; Piperacillin, Tazobactam Drug Combination
PubMed: 32598886
DOI: 10.1053/j.gastro.2020.06.051 -
Praxis Feb 2023This article describes the case of a woman who unknowingly swallowed several fishbones, one of which perforated the intestinal wall and subsequently formed an...
This article describes the case of a woman who unknowingly swallowed several fishbones, one of which perforated the intestinal wall and subsequently formed an intra-abdominal abscess due to the foreign body reaction.
Topics: Female; Humans; Abdominal Abscess; Deglutition; Foreign-Body Reaction; Fishes; Bone and Bones; Intestines
PubMed: 36722104
DOI: 10.1024/1661-8157/a003968 -
World Journal of Gastroenterology May 2015To investigate whether prophylactic abdominal drainage is necessary after pancreatic resection. (Meta-Analysis)
Meta-Analysis Review
AIM
To investigate whether prophylactic abdominal drainage is necessary after pancreatic resection.
METHODS
PubMed, Web of Science, and the Cochrane Library were systematically searched to obtain relevant articles published before January 2014. Publications were retrieved if they met the selection criteria. The outcomes of interest included: mortality, morbidity, postoperative pancreatic fistula (POPF), clinically relevant pancreatic fistula (CR-PF), abdominal abscess, reoperation rate, the rate of interventional radiology drainage, and the length of hospital stay. Subgroup analyses were also performed for pancreaticoduodenectomy (PD) and for distal pancreatectomy. Begg's funnel plot and the Egger regression test were employed to assess potential publication bias.
RESULTS
Nine eligible studies involving a total of 2794 patients were identified and included in this meta-analysis. Of the included patients, 1373 received prophylactic abdominal drainage. A fixed-effects model meta-analysis showed that placement of prophylactic drainage did not have beneficial effects on clinical outcomes, including morbidity, POPF, CR-PF, reoperation, interventional radiology drainage, and length of hospital stay (Ps > 0.05). In addition, prophylactic drainage did not significantly increase the risk of abdominal abscess. Overall analysis showed that omitting prophylactic abdominal drainage resulted in higher mortality after pancreatectomy (OR = 1.56; 95%CI: 0.93-2.92). Subgroup analysis of PD showed similar results to those in the overall analysis. Elimination of prophylactic abdominal drainage after PD led to a significant increase in mortality (OR = 2.39; 95%CI: 1.22-4.69; P = 0.01).
CONCLUSION
Prophylactic abdominal drainage after pancreatic resection is still necessary, though more evidence from randomized controlled trials assessing prophylactic drainage after PD and distal pancreatectomy are needed.
Topics: Abdominal Abscess; Adult; Aged; Aged, 80 and over; Chi-Square Distribution; Drainage; Female; Humans; Length of Stay; Male; Middle Aged; Odds Ratio; Pancreatectomy; Pancreatic Fistula; Pancreaticoduodenectomy; Reoperation; Risk Factors; Time Factors; Treatment Outcome; Young Adult
PubMed: 25987799
DOI: 10.3748/wjg.v21.i18.5719 -
Journal of Medical Imaging and... Oct 2018
Topics: Abdominal Abscess; Anus Diseases; Crohn Disease; Diagnosis, Differential; Humans; Magnetic Resonance Imaging
PubMed: 30309068
DOI: 10.1111/1754-9485.29_12784 -
Surgery Sep 2023To assess short- and long-term outcomes from non-surgical management of diverticulitis with abscess formation and to develop a nomogram to predict emergency surgery.
BACKGROUND
To assess short- and long-term outcomes from non-surgical management of diverticulitis with abscess formation and to develop a nomogram to predict emergency surgery.
METHODS
This nationwide retrospective cohort study was performed in 29 Spanish referral centers, including patients with a first episode of a diverticular abscess (modified Hinchey Ib-II) from 2015 to 2019. Emergency surgery, complications, and recurrent episodes were analyzed. Regression analysis was used to assess risk factors, and a nomogram for emergency surgery was designed.
RESULTS
Overall, 1,395 patients were included (1,078 Hinchey Ib and 317 Hinchey II). Most (1,184, 84.9%) patients were treated with antibiotics without percutaneous drainage, and 194 (13.90%) patients required emergency surgery during admission. Percutaneous drainage (208 patients) was associated with a lower risk of emergency surgery in patients with abscesses of ≥5 cm (19.9% vs 29.3%, P = .035; odds ratio 0.59 [0.37-0.96]). The multivariate analysis showed that immunosuppression treatment, C-reactive protein (odds ratio: 1.003; 1.001-1.005), free pneumoperitoneum (odds ratio: 3.01; 2.04-4.44), Hinchey II (odds ratio: 2.15; 1.42-3.26), abscess size 3 to 4.9 cm (odds ratio: 1.87; 1.06-3.29), abscess size ≥5 cm (odds ratio: 3.62; 2.08-6.32), and use of morphine (odds ratio: 3.68; 2.29-5.92) were associated with emergency surgery. A nomogram was developed with an area under the receiver operating characteristic curve of 0.81 (95% confidence interval: 0.77-0.85).
CONCLUSION
Percutaneous drainage must be considered in abscesses ≥5 cm to reduce emergency surgery rates; however, there are insufficient data to recommend it in smaller abscesses. The use of the nomogram could help the surgeon develop a targeted approach.
Topics: Humans; Abscess; Retrospective Studies; Abdominal Abscess; Nomograms; Diverticulitis; Drainage
PubMed: 37385866
DOI: 10.1016/j.surg.2023.05.016 -
Der Urologe. Ausg. A Jun 2016Retroperitoneal abscesses are rare but life threatening. Renal, perinephritic, and paranephritic abscesses are distinguished depending on their location and extent. They... (Review)
Review
BACKGROUND
Retroperitoneal abscesses are rare but life threatening. Renal, perinephritic, and paranephritic abscesses are distinguished depending on their location and extent. They are mainly caused by ascending urologic infections of gram-negative bacteria.
SYMPTOMATOLOGY
The variable symptomatology often leads to delayed diagnosis resulting in high morbidity and mortality. Typical symptoms are flank or abdominal pain, decreased appetite, weight loss, malaise, fever, and chills. Laboratory values show increased leukocytes and C‑reactive protein. Creatinine levels may also be increased.
CONCLUSION
If there is clinical evidence for a retroperitoneal abscess, sonography generally leads to further diagnostic via computed tomography. Small abscesses may be treated by antibiotics alone. Abscesses larger than 3 cm and those not responding to medical treatment should be percutaneously or surgically drained.
Topics: Abdominal Abscess; Anti-Bacterial Agents; Diagnosis, Differential; Drainage; Evidence-Based Medicine; Humans; Retroperitoneal Space; Treatment Outcome; Urinary Tract Infections
PubMed: 27220893
DOI: 10.1007/s00120-016-0118-1 -
Gastrointestinal Endoscopy Jun 2017Fistula and abscess represent penetrating disease phenotypes of Crohn's disease (CD) and can develop in patients with or without prior history of CD-related surgery.... (Review)
Review
Fistula and abscess represent penetrating disease phenotypes of Crohn's disease (CD) and can develop in patients with or without prior history of CD-related surgery. While CD fistula and abscess have been traditionally treated with medical and surgical therapy, the role of endoscopic therapy in this particular phenotype of CD is expanding recently, thanks to advanced endoscopic techniques and a better understanding of pathogenesis and natural history of the disease and principle of treatment. The success of endoscopic treatment for inflammatory bowel disease depends on comprehension and appreciation of principles, then techniques, followed by instrument and device. Attempts should be made to temporarily or permanently close the feeding side (or the primary) orifice at the gut, by various forms of clipping. Endoscopic fistulotomy is feasible, particularly for perianal fistula and surgery-associated distal bowel fistula. Perianal abscess can be treated with endoscopic incision and drainage and even seton placement. Endoscopic treatment for fistula and abscess as well as for stricture has become an important part of the multidisciplinary approach to complex CD.
Topics: Abdominal Abscess; Crohn Disease; Drainage; Endoscopy, Gastrointestinal; Female; Humans; Intestinal Fistula; Male; Rectal Fistula; Rectovaginal Fistula
PubMed: 28153572
DOI: 10.1016/j.gie.2017.01.025 -
Acta Clinica Croatica Sep 2019We present an atypical case of retrouterine gangrenous perforated appendicitis with Douglas abscess in a 33-year-old woman, with clinical picture developing over two...
We present an atypical case of retrouterine gangrenous perforated appendicitis with Douglas abscess in a 33-year-old woman, with clinical picture developing over two weeks. Laparotomy and appendectomy with abdominal drainage and antibiosis were performed and resulted in complete recovery.
Topics: Abdominal Abscess; Adult; Appendectomy; Appendicitis; Female; Gangrene; Humans; Laparoscopy; Treatment Outcome; Uterine Perforation
PubMed: 31969773
DOI: 10.20471/acc.2019.58.03.24 -
Surgery May 2023The aim of this meta-analysis and systematic review was to evaluate the association between intraoperative bile cultures and postoperative complications of patients... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The aim of this meta-analysis and systematic review was to evaluate the association between intraoperative bile cultures and postoperative complications of patients undergoing pancreaticoduodenectomy.
METHODS
A detailed literature search was performed from January 2015 to July 2022 in PubMed, Web of Science, Google Scholar, and EMBASE for related research publications. The data were extracted, screened, and graded independently. An analysis of pooled data was performed, and a risk ratio with corresponding confidence intervals was calculated and summarized.
RESULTS
A total of 8 articles were included with 1,778 pancreaticoduodenectomy patients who had an intraoperative bile culture performed. A systematic review demonstrated that some of the most common organisms isolated in a positive intraoperative bile culture were Enterococcus species, Klebsiella species, and E. coli. Four studies also showed that specific microorganisms were associated with specific postoperative complications (surgical site infection and intra-abdominal abscess). The postoperative complications that were evaluated for an association with a positive intraoperative bile culture were surgical site infections (risk ratio = 2.33, 95% confidence interval [1.47-3.69], P < .01), delayed gastric emptying (risk ratio = 1.23, 95% confidence interval [0.63-2.38], P = n.s.), 90-day mortality (risk ratio = 0.68, 95% confidence interval [0.01-52.76], P = n.s.), postoperative pancreatic hemorrhage (risk ratio = 1.70, 95% confidence interval [0.33-8.74], P = n.s.), intra-abdominal abscess (risk ratio = 1.70, 95% confidence interval [0.38-7.56], P = n.s.), and postoperative pancreatic fistula (risk ratio = 0.97, 95% confidence interval [0.72-1.32], P = n.s.).
CONCLUSION
The cumulative data suggest that a positive intraoperative bile culture has no association with predicting the postoperative complications of delayed gastric emptying, 90-day mortality, postoperative pancreatic hemorrhage, intra-abdominal abscess, or postoperative pancreatic fistula. However, the data also suggest that a positive intraoperative bile culture was associated with a patient developing a surgical site infection.
Topics: Humans; Pancreaticoduodenectomy; Surgical Wound Infection; Pancreatic Fistula; Bile; Gastroparesis; Escherichia coli; Pancreatic Diseases; Postoperative Hemorrhage; Abdominal Abscess; Postoperative Complications
PubMed: 36707272
DOI: 10.1016/j.surg.2022.12.012