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Chirurgia (Bucharest, Romania : 1990) 2019Abdominal actinomycosis is a rare granulomatous inflammatory disease caused by a Gram-positive anaerobic bacterium Actinomyces israelii, manifesting as inflammatory...
Abdominal actinomycosis is a rare granulomatous inflammatory disease caused by a Gram-positive anaerobic bacterium Actinomyces israelii, manifesting as inflammatory mass, or abscess formation. Evolution is slow and steady in inflammatory contiguous extension without limit organ that lends itself to confusion with abdominal malignancies. We performed a retrospective study on the patients with abdominal actinomycosis operated in the First Surgical Clinic, "St. Spiridon" University Hospital Iasi; between 1980 - 2018 there have been 13 cases (4 men and 9 women) with a mean age 44.07 years admitted for abdominal tumors (7 cases) or pelvic inflammatory disease (6 cases). We identified as predisposing factors: IUD maintained over 10 years (6 cases), foreign bodies 2 cases (a toothpick probably perforated colon, gallstones lost in peritoneum), diabetes (3 cases), immunodepression. All cases were operated by laparotomy (9 cases) or laparoscopic approach (4 cases). We describe five of these cases of actinomycosis that had been mimicking a colon cancer: ileo - cecal - 3 cases, transverse colon - one case and on the greater omentum - one case, followed by specific treatment with penicillin, with good evolution. Abdominal actinomycosis should always be included in the differential diagnosis of abdominal tumors. Preoperative diagnosis, difficult but possible, can avoid surgery. Treatment with antibiotics is necessary for the healing of the disease. Postoperative control is mandatory, with relapses possible.
Topics: Abdominal Abscess; Abdominal Neoplasms; Actinomycosis; Adult; Anti-Bacterial Agents; Colonic Neoplasms; Diagnosis, Differential; Female; Humans; Laparoscopy; Male; Middle Aged; Penicillins; Recurrence; Retrospective Studies; Treatment Outcome
PubMed: 31060658
DOI: 10.21614/chirurgia.114.2.251 -
Polski Przeglad Chirurgiczny May 2022<b> Aim: </b> The study was conducted to analyse the recent peer-reviewed literature related to symptomatic spilled gallstones after Laparoscopic...
<b> Aim: </b> The study was conducted to analyse the recent peer-reviewed literature related to symptomatic spilled gallstones after Laparoscopic Cholecystectomy (LC). </br></br> <b>Materials and methods:</b> Articles published in the peer-reviewed journals of repute from 20122022 were evaluated for nine variables including: [I] age of the patient, [II] gender, [III] interval since index LC, [IV] index LC if emergent/difficult or elective/straightforward, [V] clinical presentation, [VI] spilled gallstones if detected by imaging, [VII] management, [VIII] approach to management, [IX] number of spilled gallstones. </br></br> <b>Results:</b> There were a total of 71 cases (37 males and 34 females) with a mean age of 63.7 years. The time of onset of symptoms from spilled gallstones, after index LC, ranged from 2 days to 15 years and 57 patients (80.3%) presented within 6 years. Forty (56.3%) patients were unaware of the fact that gallstone spillage had occurred during index LC. The retained gallstones were detected by imaging in 47 (66.1%) cases and they were multiple in 51 (71.8%). In 52 patients (73.2%), the stones manifested as abdominal abscess/foreign body granuloma; the other presentations being pelvic pain/fistula, intestinal obstruction, abdominal lump simulating malignancy, incidental finding of metastatic lesions and generalized peritonitis. The major approaches adopted to retrieve the retained stones included open surgery, laparoscopy and percutaneous drainage. There were two deaths (2.9%) due to spilled gallstones. </br></br> <b>Conclusion:</b> Retained gallstones represent a complication of laparoscopic cholecystectomy (LC) that has a potential to create morbidity and diagnostic difficulties, even after a substantial delay. There is a need to spread awareness about the adverse effects of spilled stones so that they are actively looked for and retrieved if gallbladder perforates during cholecystectomy. Whenever such a complication occurs, the patient should be properly informed and the details should be very clearly mentioned in the operation notes.
Topics: Female; Male; Humans; Middle Aged; Gallstones; Cholecystectomy, Laparoscopic; Cholecystectomy; Laparoscopy; Abdominal Abscess; Abdominal Neoplasms
PubMed: 36805307
DOI: 10.5604/01.3001.0015.8571 -
Alimentary Pharmacology & Therapeutics Nov 2014One-third of Crohn's disease (CD) patients will undergo abdominal surgery within the first 5 years of diagnosis. (Review)
Review
BACKGROUND
One-third of Crohn's disease (CD) patients will undergo abdominal surgery within the first 5 years of diagnosis.
AIM
To review the available evidence on pre-operative optimisation of CD patients.
METHODS
The literature regarding psychological support, radiological imaging, abdominal abscess management, nutritional support, thromboembolic prophylaxis and immunosuppression in the perioperative setting was reviewed.
RESULTS
For diagnosis of fistulas, abscesses and stenosis, ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) have a high diagnostic accuracy. Under either CT or US guidance, it is possible to perform abscess percutaneous drainage (PD), which, with systemic antibiotic therapy, should be the first-line approach to intra-abdominal abscesses. CD patients with weight loss <10% within the last 3-6 months, body mass index < 18.5 kg/m(2) and/or albumin levels <30 g/L, are at an increased risk of post-operative complications. Pre-operative nutritional support should be used in these patients. IBD patients undergoing surgery have a higher risk of venous thromboembolic disease than patients with colorectal cancer, and current guidelines recommend that they should receive prophylaxis with heparin. Whether the use of anti-TNF agents before surgery increases the likelihood of post-operative complications, is the subject of much debate. To date, cumulative evidence from most studies (all retrospective) suggests that there is no such risk increment. Prospective studies are necessary to firmly establish this conclusion.
CONCLUSIONS
Preparation for surgery requires close interaction between surgeons, gastroenterologist, radiologists, psychologists and the patient. Correct pre-operative planning of surgical treatment has a major impact on the outcome of such treatment.
Topics: Abdominal Abscess; Anti-Bacterial Agents; Crohn Disease; Female; Humans; Magnetic Resonance Imaging; Male; Postoperative Complications; Preoperative Care; Prospective Studies; Retrospective Studies; Tomography, X-Ray Computed; Tumor Necrosis Factor-alpha
PubMed: 25209947
DOI: 10.1111/apt.12947 -
Revista Espanola de Enfermedades... Dec 2020We report the case of a 90-year-old female who was admitted to our hospital due to a three-day history of right abdominal pain and fever of 39 °C (102 °F). The...
We report the case of a 90-year-old female who was admitted to our hospital due to a three-day history of right abdominal pain and fever of 39 °C (102 °F). The patient's blood pressure was low, with good blood perfusion and no jaundice, and her abdomen was soft and tender in the right hypochondriac and lateral region, with no guarding. Laboratory tests showed: blood glucose level of 201 mg/dl, 362 U/l AST, 237 U/l ALT, 2.5 mg/dl bilirubin, 237 U/l alkaline phosphatase and leukocytosis associated with a left shift. An abdominal ultrasound scan showed a collection of echogenic material and a shadow suggestive of air in hepatic segment 3. Meropenem and metronidazole treatment was started after taking blood cultures, which were negative. A computed tomography (CT) scan confirmed the presence of a liver abscess in segment 3, containing a high-density linear image.
Topics: Aged, 80 and over; Arcanobacterium; Female; Humans; Liver Abscess; Metronidazole; Ultrasonography
PubMed: 33054279
DOI: 10.17235/reed.2020.7029/2020 -
La Radiologia Medica Dec 2021CT-guided percutaneous drainage is a safe and effective procedure that allows minimally invasive treatment of abdominopelvic abscesses and fluid collections. This... (Review)
Review
CT-guided percutaneous drainage is a safe and effective procedure that allows minimally invasive treatment of abdominopelvic abscesses and fluid collections. This technique has become an alternative for surgery with lower morbility and mortality rates. In this pictorial essay, we aim at providing an overview of the technical approaches, the main clinical indications and complications of CT-guided percutaneous drainage, in order to provide a practical guide for interventional radiologists, with a review of the recent literature. The focus will be the CT-guidance, preferred when the interposition of viscera, vascular and skeletal structures, counteracts the ultrasound guidance.
Topics: Abdominal Abscess; Drainage; Humans; Radiography, Interventional; Tomography, X-Ray Computed
PubMed: 34415507
DOI: 10.1007/s11547-021-01406-z -
BMJ Case Reports Aug 2019
Topics: Abdominal Abscess; Bodily Secretions; Corynebacterium; Corynebacterium Infections; Female; Humans; Umbilicus; Urachus; Young Adult
PubMed: 31420441
DOI: 10.1136/bcr-2019-231139 -
Acta Gastro-enterologica Belgica 2020Entamoeba histolytica infections are rare in developed countries such as Belgium. A 53-year-old female patient presented with 10 days of fever and mild persisting pain...
Entamoeba histolytica infections are rare in developed countries such as Belgium. A 53-year-old female patient presented with 10 days of fever and mild persisting pain in the right hypochondriac despite 6 days of antibiotic therapy. The anamnesis further revealed that the patient was born in Colombia and visits her native country on a regular basis. An abdominal CT-scan demonstrated a large hepatic abscess of 10×8 cm. The diagnosis of Entamoeba histolytica- infection was confirmed with real-time PCR (RT-PCR) from the aspirated material of the abscess. Remarkably, a half year ago, this patient also presented to the gastro-enterology consultation with intermittent rectal bleeding, loose stools and abdominal discomfort. Rectosigmoidoscopy at that time showed sigmoiddiverticulosis and biopsies were taken. RT-PCR on this material was performed during this second episode and was positive for E. histolytica, confirming an episode of amoebic colitis a half year prior to the discovery of the liver abscess.
Topics: Belgium; Entamoeba histolytica; Entamoebiasis; Female; Fever; Humans; Liver Abscess, Amebic; Middle Aged; Travel
PubMed: 32603057
DOI: No ID Found -
Asian Journal of Surgery Jun 2023
Topics: Female; Humans; Liver Abscess; Abdominal Abscess; Abdomen
PubMed: 36610906
DOI: 10.1016/j.asjsur.2022.12.099 -
Medicine May 2018Pyogenic liver abscess (PLA) are space-occupying lesions in the liver associated with high morbidity and mortality. The aim of this study is to review an Italian... (Observational Study)
Observational Study
Pyogenic liver abscess (PLA) are space-occupying lesions in the liver associated with high morbidity and mortality. The aim of this study is to review an Italian hospital experience in epidemiological, clinical patterns, and management of PLA.We performed a retrospective, descriptive case series at a single center assessing demographic characteristics, presentation patterns, etiological factors, microbiological etiology, and management for patients treated for PLA between 2000 and 2016.Around 109 patients were identified. The majority of patients presented with fever (73%); right upper abdominal pain in 63.3%, vomiting and nausea in 28.4%. The most common laboratory abnormality among included items was increased C-reactive protein and fibrinogen blood levels, respectively, in 98% and 93.9% of cases. Abdominal ultrasound was the diagnostic investigation in 42.4% of cases; CT scan and MR imaging were performed in 51.1% and 3.3% of cases respectively. We observed blood or pus culture study in 99 cases of which only 53.5% came with positive microbial reports. The most common organism identified was Escherichia coli (26.5%), followed by Streptococcus spp (13.2%). Early antibiotic treatment started on all patients and 66.7% of cases required different approaches, Ultrasound or CT-guided needle aspiration of PLA was performed in 13 patients (11%) and percutaneous abscess drainage was performed on 72 patients (67%).PLA is a diagnostically challenging problem due to nonspecific presenting characteristics. The microbiological yield identified was a typical European spectrum with a preponderance of Escherichia coli infections. Once recognized, percutaneous drainage and antibiotic treatment are the mainstay of management for PLA.
Topics: Adult; Anti-Bacterial Agents; Biliary Fistula; Drainage; Escherichia coli; Female; Humans; Italy; Liver; Liver Abscess, Pyogenic; Magnetic Resonance Imaging; Male; Middle Aged; Outcome and Process Assessment, Health Care; Pneumothorax; Postoperative Complications; Streptococcus; Tomography, X-Ray Computed
PubMed: 29742700
DOI: 10.1097/MD.0000000000010628 -
European Journal of Pediatrics Sep 2016This study aims to provide an overview of both our own experience and the available literature on the treatment of post-appendectomy abscess (PAA) in children. We... (Review)
Review
UNLABELLED
This study aims to provide an overview of both our own experience and the available literature on the treatment of post-appendectomy abscess (PAA) in children. We performed a historical cohort study encompassing all children aged 0-17 years old treated for a radiologically confirmed PAA between 2007 and 2013. Their medical charts were reviewed and descriptive analyses were performed. A literature search on the treatment of PAA in children was performed. In our cohort, 25 out of 372 (7 %) children developed a PAA. Thirteen were treated with a noninvasive strategy and 12 with an invasive strategy (percutaneous or surgical drainage). The immediate success rate was 9/13 (69 %) and 8/12 (67 %) for the noninvasive and invasive strategy, respectively. In both groups, four children (31 and 33 % resp.) required delayed interventions after their initial treatment. In the literature review, six studies were included which reported a median (range) frequency of persistent or recurrent abscess of 9 % (0-30 %), 50 % (0-100 %) and 24 % (0-33 %) for the antibiotic (noninvasive), percutaneous drainage (invasive) and surgical drainage strategies, respectively.
CONCLUSION
Although confounding by indication cannot be excluded, we recommend noninvasive treatment as a safe strategy for PAA in children with stable condition.
WHAT IS KNOWN
• Post-appendectomy abscess is a well-known and feared complication, occurring in up to 24 % of the children treated surgically for appendicitis. • Several strategies are available to treat this condition, all with advantages and disadvantages. What is new: • Noninvasive strategy is a safe strategy for children with a PAA in a stable condition. • An overview of the literature (the first to our knowledge) supports the above-mentioned statement.
Topics: Abdominal Abscess; Adolescent; Anti-Bacterial Agents; Appendectomy; Child; Child, Preschool; Drainage; Female; Humans; Laparoscopy; Length of Stay; Male; Postoperative Complications; Radiography; Retrospective Studies; Ultrasonography
PubMed: 27511046
DOI: 10.1007/s00431-016-2756-0