RESUMEN
A rare case, presented as a secondary aortoenteric fistula after an abdominal aortic aneurysmectomy with Y-graft replacement 9 months earlier, is reported. The course was clinically very unique, in that the first manifestation of the aorto enteric fistula occurred while the patient had already been hospitalized after the orthopaedic surgical treatment for the pyogenic vertebral spondylitis. After the episode of gastrointestinal bleeding, radiological studies were promptly collected, and with the proper diagnosis, a successful surgical treatment was given under the stable hemodynamic condition, and the patient recovered uneventfully. Retrospectively considered, there are several findings that would suggest that seemingly a secondary aorto enteric fistula could have resulted from an early process of the primary aorto enteric fistula having been under progress without any detectable manifestations before the previous aneurysmectomy. The diagnostic values of computed tomography and the scintigraphy for this rare clinical entity is also underlined.
Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Enfermedades de la Aorta/etiología , Fístula Intestinal/etiología , Anciano , Aorta Abdominal , Aneurisma de la Aorta Abdominal/complicaciones , Enfermedades de la Aorta/diagnóstico , Enfermedades de la Aorta/cirugía , Humanos , Fístula Intestinal/diagnóstico , Fístula Intestinal/cirugía , Vértebras Lumbares/cirugía , Masculino , Complicaciones Posoperatorias , Falla de Prótesis , Espondilitis/cirugíaRESUMEN
Cefsulodin (CFS), a new antipseudomonas cephalosporin, was clinically evaluated for treatment of the Pseudomonas aeruginosa infections in the surgical field to obtain the following results. 1. CFS was administered to total 11 cases of the surgical infections caused by P. aeruginosa, comprising of 5 cases with wound infections, 3 cases with infected burn and 1 case each with muscular abscess, decubitus and postoperative pneumonia in 0.5 approximately 1 g twice a day by intravenous bolus or drip infusion. Good clinical responses were obtained in 9 out of 11 cases (81.8%). 2. Bacteriological responses were observed in all cases. P. aeruginosa was eradicated in 9 cases and suppressed in 2 cases by CFS treatment. However, replacement of pathogens with the other organisms was observed in 6 out of 8 cases caused by P. aeruginosa only. 3. Neither objective and subjective side effects nor abnormalities of laboratory tests associated with CFS treatment were observed. 4. It can be, therefore, concluded that CFS is one of the useful drugs for treatment of the surgical infections caused by P. aeruginosa.