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Medicina 2016
Topics: Abdominal Abscess; Colostomy; Female; Humans; Middle Aged; Retroperitoneal Space; Tomography, X-Ray Computed
PubMed: 27959853
DOI: No ID Found -
Journal of Gastrointestinal Surgery :... Nov 2023
Topics: Humans; Lymphangioma, Cystic; Liver Neoplasms; Abdominal Abscess
PubMed: 37280460
DOI: 10.1007/s11605-023-05705-w -
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 -
International Journal of Urology :... May 1999A case report of patient with an intra-abdominal abscess 8 weeks after radical cystectomy and construction of an ileal neobladder is presented. (Review)
Review
PURPOSE
A case report of patient with an intra-abdominal abscess 8 weeks after radical cystectomy and construction of an ileal neobladder is presented.
METHODS/RESULTS
The patient was admitted with nausea, vomiting and singultus. A perforation of the neobladder due to overdistension was assumed to be the underlying cause of the intra-abdominal abscess formation as the patient admitted infrequent voiding during the day and no emptying of the neobladder at night. The patient underwent explorative laparotomy and 4200 mL of pus was removed from the abdominal cavity. The patient made an uneventful recovery and was discharged from hospital after 5 weeks. Neobladder function remained stable and the patient was leading a normal life at 24 months follow-up.
CONCLUSIONS
The present case demonstrates the need for careful patient selection prior to radical cystectomy with continent urinary diversion. Reduced compliance and mental disabilities of a patient can increase the complication rate.
Topics: Abdominal Abscess; Adult; Anti-Bacterial Agents; Carcinoma, Transitional Cell; Drug Therapy, Combination; Follow-Up Studies; Humans; Ileum; Laparotomy; Male; Radiography, Abdominal; Tomography, X-Ray Computed; Treatment Refusal; Urinary Bladder Neoplasms; Urinary Diversion
PubMed: 10375191
DOI: 10.1046/j.1442-2042.1999.00053.x -
ANZ Journal of Surgery Dec 2019
Topics: Abdominal Abscess; Adolescent; Anti-Bacterial Agents; Crohn Disease; Drainage; Humans; Injections, Intravenous; Male; Tomography, X-Ray Computed
PubMed: 30675978
DOI: 10.1111/ans.14977 -
The Journal of Surgical Research Dec 2020
Topics: Abdominal Abscess; Appendectomy; Drainage; Humans
PubMed: 32917389
DOI: 10.1016/j.jss.2020.08.032 -
Journal of Crohn's & Colitis Apr 2024Intra-abdominal abscesses complicating Crohn's disease [CD] are a challenging situation. Their management, during hospitalisation and after resolution, is still unclear.
Initial Management of Intra-abdominal Abscesses and Preventive Strategies for Abscess Recurrence in Penetrating Crohn's Disease: A National, Multicentre Study Based on ENEIDA Registry.
INTRODUCTION
Intra-abdominal abscesses complicating Crohn's disease [CD] are a challenging situation. Their management, during hospitalisation and after resolution, is still unclear.
METHODS
Adult patients with CD complicated with intra-abdominal abscess. who required hospitalisation, were included from the prospectively maintained ENEIDA registry from GETECCU. Initial strategy effectiveness and safety to resolve abscess was assessed. Survival analysis was performed to evaluate recurrence risk. Predictive factors associated with resolution were evaluated by multivariate regression and predictive factors associated with recurrence were assessed by Cox regression.
RESULTS
In all, 520 patients from 37 Spanish hospitals were included; 322 [63%] were initially treated with antibiotics alone, 128 [26%] with percutaneous drainage, and 54 [17%] with surgical drainage. The size of the abscess was critical to the effectiveness of each treatment. In abscesses < 30 mm, the antibiotic was as effective as percutaneous or surgical drainage. However, in larger abscesses, percutaneous or surgical drainage was superior. In abscesses > 50 mm, surgery was superior to percutaneous drainage, although it was associated with a higher complication rate. After abscess resolution, luminal resection was associated with a lower 1-year abscess recurrence risk [HR 0.43, 95% CI 0.24-0.76]. However, those patients who initiated anti-TNF therapy had a similar recurrence risk whether luminal resection had been performed.
CONCLUSIONS
Small abscesses [<30mm] can be managed with antibiotics alone; larger ones require drainage. Percutaneous drainage will be effective and safer than surgery in many cases. After discharge, anti-TNF therapy reduces abscess recurrence risk in a similar way to bowel resection.
Topics: Humans; Crohn Disease; Abdominal Abscess; Male; Female; Drainage; Adult; Registries; Anti-Bacterial Agents; Recurrence; Spain; Middle Aged; Secondary Prevention
PubMed: 37930823
DOI: 10.1093/ecco-jcc/jjad184 -
Diseases of the Colon and Rectum Jan 1996Actinomyces israelii are normal inhabitants in the oral cavity and upper intestinal tract of humans. They rarely cause disease and are seldom reported as pathogens. As a... (Review)
Review
PURPOSE
Actinomyces israelii are normal inhabitants in the oral cavity and upper intestinal tract of humans. They rarely cause disease and are seldom reported as pathogens. As a pathogen it causes fistulas, sinuses, and may appear as an abdominal mass and/or abscess. The abdominal mass can masquerade as a malignant process that is very difficult to differentiate, often requiring surgical intervention with resection. Because of difficulty in making a preoperative diagnosis, we undertook this review to determine if all patients require surgical intervention and whether other adjunctive modalities may improve preoperative diagnosis.
METHODS
We report two patients with abdominal actinomycosis, one affecting the sigmoid colon and the other the retroperitoneum, iliac crest region. Both simulated a malignant process and required operations for diagnosis and treatment.
RESULTS
As reported, actinomycotic abdominal masses and strictures can be treated by penicillin alone. Long-term medical treatment seems to be very successful and avoids surgical resection. The difficulty is obtaining a definitive diagnosis.
CONCLUSION
The computed tomographic scan is the most helpful diagnostic modality. Appearance of abdominal actinomycosis is usually a contrast enhancing multicystic lesion as was found in these two patients. Needle aspiration cytology can be fairly accurate in obtaining the diagnosis and is recommended for suspicious lesions.
Topics: Abdominal Abscess; Actinomycosis; Adult; Biopsy, Needle; Diagnosis, Differential; Humans; Male; Middle Aged; Retroperitoneal Space; Sigmoid Diseases; Tomography, X-Ray Computed
PubMed: 8601346
DOI: 10.1007/BF02048278 -
Medicine Sep 2019Failure to pass though the gastrointestinal tract can result in inflammatory response, reactive fibrosis, and intestinal perforation. Fish bones, chicken bones, and...
RATIONALE
Failure to pass though the gastrointestinal tract can result in inflammatory response, reactive fibrosis, and intestinal perforation. Fish bones, chicken bones, and toothpicks are the most common types of foreign substances that produce intestinal perforation during ingestion.
PATIENT CONCERNS
Case 1: A 49-year-old female was hospitalized with abdominal pain and a fever. The fever lasted for 5 days before hospitalization. Case 2: A 72-year-old male was hospitalized with abdominal pain and fever. The fever lasted for 4 days before hospitalization.
DIAGNOSES
Case 1: An abdominal pelvic computed tomography (APCT) scan revealed a large inflammatory mass formation and linear high-density material within the inflammatory mass. The presence of foreign bodies, including acupuncture needles or intrauterine devices was ruled out. Case 2: An APCT scan revealed that there was a small abscess formation measuring about 2.5 cm abutting the abdominal wall and a parasitic infestation was ruled out.
INTERVENTIONS
Case 1: An exploratory laparotomy was performed. After removal of the abscess pocket, the sigmoid colon was found to be perforated, and there was a firm, sharp foreign body in the abscess pocket that measured about 5 cm and resembled a toothpick. Case 2: Laparoscopic exploration was then performed. When the abscess was removed from the abdominal wall using a harmony scalpel, a 4 cm foreign body that resembled a toothpick appeared in the abscess pocket.
OUTCOMES
The patients recovered well after surgery and were discharged.
LESSONS
Two of the above case reports describe the cases in which the presence of toothpicks was suspected clinically, resulting in the surgery of intra-abdominal abscess caused by intestinal perforations.
Topics: Abdominal Abscess; Aged; Colon, Sigmoid; Female; Foreign-Body Reaction; Humans; Intestinal Perforation; Male; Middle Aged
PubMed: 31490392
DOI: 10.1097/MD.0000000000017032 -
Veterinary Surgery : VS Nov 2014To report the clinical signs, diagnostic findings, surgical treatment, postoperative complications, and long-term outcome in 2 adult alpacas with large intra-abdominal...
OBJECTIVES
To report the clinical signs, diagnostic findings, surgical treatment, postoperative complications, and long-term outcome in 2 adult alpacas with large intra-abdominal abscesses treated by marsupialization of the abscess to the ventral body wall.
STUDY DESIGN
Clinical report.
ANIMALS
Alpacas (n = 2).
METHODS
Two alpacas each presented with decreased appetite, lethargy, poor body condition, and marked abdominal distension. A complete physical examination, abdominal radiography, and ultrasonography confirmed the presence of large intra-abdominal abscesses. Streptococcus equi ssp. zooepidemicus was cultured from the abscess fluid of alpaca 1, and a Gram-negative bacillus from alpaca 2.
RESULTS
Both alpacas had exploratory celiotomy with marsupialization of the abdominal abscess to the ventral body wall. Postoperatively, alpacas were administered systemic antibiotics and non-steroidal anti-inflammatory drugs, and the abscesses were lavaged for several days. Alpaca 2 required a second surgical procedure. The abscesses ultimately resolved in both alpacas, with body wall hernia formation as the only major complication. Both alpacas had good long-term outcomes.
CONCLUSION
Marsupialization to the ventral abdominal wall with concurrent antibiotic treatment should be considered as a treatment option for alpacas with large intra-abdominal abscesses in which complete surgical resection of the abscess is not possible. An abdominal wall hernia can result from this procedure, and clients should be informed of this potential complication before surgery.
Topics: Abdominal Abscess; Animals; Camelids, New World; Diagnosis, Differential; Drainage; Female; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Streptococcal Infections; Streptococcus
PubMed: 25209613
DOI: 10.1111/j.1532-950X.2014.12271.x