ABSTRACT
BACKGROUND: Splenic abscess is a rare disease, with incidence of 0.2-0.7% in previous studies. It often appears with left upper quadrant abdominal pain, fever, chills. Splenic abscess often happens because of hematogenous spreading of infections, endocarditis, angioembolization and some other rare reasons. Treatment relies on one of these two methods: percutaneous drainage or surgery. CASE PRESENTATION: A 68-year-old diabetic Asian female (Asian woman) presented with generalized abdominal pain, low blood pressure, tachycardia, fever, lethargy and elevated level of blood sugar. She had history of conservative therapy in intensive care unit due to blunt abdominal trauma and splenic injury. She had a huge splenic abscess in ultrasonography and computed tomography scan so she went under splenectomy. Our patient had a splenic abscess without performing any intervention like angioembolization. CONCLUSION: Immune compromised patients who are selected for nonoperative management after splenic injury need close follow up and evaluating about abscess formation for at least 2 weeks. Early diagnosis and treatment with two methods including percutaneous drainage or splenectomy should be considered and it depends on patient's risk factors, vital signs, general conditions and presence or absence of sepsis.
Subject(s)
Abdominal Abscess , Intraabdominal Infections , Splenic Diseases , Humans , Female , Aged , Splenic Diseases/diagnostic imaging , Splenic Diseases/etiology , Splenic Diseases/therapy , Abscess/diagnostic imaging , Abscess/therapy , Abscess/complications , Abdominal Abscess/diagnostic imaging , Abdominal Abscess/etiology , Abdominal Abscess/therapy , Splenectomy , Abdominal Pain/etiologyABSTRACT
<b> Introduction:</b> Anastomotic leak after colorectal surgery is a serious complication that causes significant postoperative morbidity and mortality. </br></br> <b>Aim:</b> This study aimed to investigate the predictive value of increased postoperative carcinoembryonic antigen (CEA) in early intestinal anastomosis leakage in patients who underwent right hemicolectomy surgery.</br></br> <b>Material and methods:</b> In this prospective study, 535 patients who underwent right colon cancer surgery with stapled anastomosis were enrolled. A subset of 315 patients was included in the study after meeting the inclusion criteria. Preoperatively, their serum CEA levels were measured, and on postoperative days 3 and 6, the levels were measured again.</br></br> <b>Results:</b> Early AL occurred in 18 patients (5.71%). The mean SD age of patients was 65.06 11.69 years. Increased CEA level was associated with increased odds of intestinal AL among the patients after three and six days of surgery (OR after three days = 1.3; 95%CI = 1.11.5, OR after six days = 1.7 95%CI = 1.142.5). The mean CEA level significantly increased among patients with anastomose leakage (P-value < 0.001). </br></br> <b>Conclusion:</b> The results showed that increasing CEA levels can be used as one of the non-invasive markers in detecting early AL in patients with right colon cancer surgery.
