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1.
Nihon Shokakibyo Gakkai Zasshi ; 119(8): 744-749, 2022.
Artigo em Japonês | MEDLINE | ID: mdl-35944992

RESUMO

A female in her 60s was referred to our institution with epigastric pain and abdominal fullness persisting for one week. She was afebrile and mild abdominal tenderness was found on physical examination. Computed tomography (CT) revealed free air, and the dirty fat sign outside the duodenal wall. Her previous CT had not shown causative findings such as duodenal diverticula. A slightly high-attenuated linear structure penetrating the duodenal wall at the second portion was suspected after review of present CT images. Based on the history of her current illness, the possibility of mackerel bone ingestion was considered. Esophagogastroduodenoscopy (EGD) revealed a fishbone sticking out of the duodenal wall, which was extracted with biopsy forceps. Although antibiotic treatment under fasting was continued, the formation of retroperitoneal abscess was detected by CT on the 6th postprocedural day. Given that she also developed a high fever, surgical drainage was performed. The patient was discharged on the 15th postoperative day. Thus, in cases of duodenal perforations, a fishbone should be taken into account as a possible cause. Even if endoscopic removal was initially selected, careful observation is mandatory and an additional treatment should be considered depending on the clinical course.


Assuntos
Úlcera Duodenal , Perfuração Intestinal , Dor Abdominal/etiologia , Abscesso/complicações , Drenagem , Úlcera Duodenal/complicações , Duodeno/cirurgia , Feminino , Humanos , Perfuração Intestinal/diagnóstico por imagem , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia
2.
Front Cell Infect Microbiol ; 12: 958210, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35967860

RESUMO

A tubo-ovarian abscess (TOA) is a common type of inflammatory lump in clinical practice. TOA is an important, life-threatening disease, and it has become more common in recent years, posing a major health risk to women. Broad-spectrum antimicrobial agents are necessary to cover the most likely pathogens because the pathogens that cause TOA are polymicrobial. However, the response rate of antibiotic treatment is about 70%, whereas one-third of patients have poor clinical consequences and they require drainage or surgery. Rising antimicrobial resistance serves as a significant reason for the unsatisfactory medical outcomes. It is important to study the antibiotic resistance mechanism of TOA pathogens in solving the problems of multi-drug resistant strains. This paper focuses on the most common pathogenic bacteria isolated from TOA specimens and discusses the emerging trends and epidemiology of resistant Escherichia coli, Bacteroides fragilis, and gram-positive anaerobic cocci. Besides that, new methods that aim to solve the antibiotic resistance of related pathogens are discussed, such as CRISPR, nanoparticles, bacteriophages, antimicrobial peptides, and pathogen-specific monoclonal antibodies. Through this review, we hope to reveal the current situation of antibiotic resistance of common TOA pathogens, relevant mechanisms, and possible antibacterial strategies, providing references for the clinical treatment of drug-resistant pathogens.


Assuntos
Abscesso , Infecções Bacterianas , Abscesso/induzido quimicamente , Abscesso/tratamento farmacológico , Abscesso/microbiologia , Antibacterianos/efeitos adversos , Bactérias , Infecções Bacterianas/tratamento farmacológico , Resistência Microbiana a Medicamentos , Feminino , Humanos
3.
Rev Med Liege ; 77(7-8): 426-429, 2022 Jul.
Artigo em Francês | MEDLINE | ID: mdl-35924496

RESUMO

With the development of modern imaging, incidental findings of renal neoplasia are increasingly frequent. However, renal cell carcinoma can also rarely present as an atypical form and can be confused with benign pathologies such as renal abscess or pyelonephritis. We present the case of a renal neoplasia largely mimicking a renal abscess.


Avec le développement de l'imagerie moderne, la découverte fortuite des néoplasies rénales est de plus en plus fréquente. Néanmoins, le carcinome rénal peut également rarement se présenter sous une forme atypique et peut alors être confondu avec des pathologies bénignes comme un abcès rénal ou une pyélonéphrite. Nous présentons le cas d'une néoplasie rénale se manifestant trompeusement sous la forme d'un abcès rénal.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Pielonefrite , Infecções Urinárias , Abscesso/diagnóstico , Carcinoma de Células Renais/diagnóstico , Diagnóstico Diferencial , Humanos , Neoplasias Renais/diagnóstico , Pielonefrite/diagnóstico
4.
Wiad Lek ; 75(6): 1634-1641, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35962672

RESUMO

OBJECTIVE: The aim: To assess the role of surgical site infections types associated with obstetric and gynecological surgeries as a cause of infertility among women reproductive age in Ukraine. PATIENTS AND METHODS: Materials and methods: We conducted a retrospective multicentre cohort study was based on reproductive health surveillance data among women reproductive age from 2019 to 2021. Definitions of infertility were used from the WHO and surgical site infections were used CDC/ NHSN. RESULTS: Results: Among all the 3,825 of infertility women in this study, the prevalence of surgical site infection (SSI) was 67.9%. The prevalence of SSI among primary infertility group and secondary infertility group women was 67.5% and 71.4%, respectively. There were differences among SSI type associated with infertility, primary infertility and secondary infertility. In logistic multivariate regression analyses, infertility was associated history of induced abortion (p < 0.001), history of obstetric and gynecological surgeries (p < 0.001), Salpingitis (p < 0.001), Oophoritis (p < 0.001), Endometritis (p < 0.001), Adnexa utery (p=0.009), and Pelvic abscess or cellulitis (p=0.043). The main factors associated with primary infertility were history of Salpingitis (33.6%) and Oophoritis (28.2%) after gynecological surgery. A factors associated with secondary infertility were history of Endometritis (27.2%), Pelvic abscess or cellulitis (11.2%), Salpingitis (10.1%), Adnexa utery (9.4%), Oophoritis (4.8%), and Chorioamnionitis (3.9%). CONCLUSION: Conclusions: One of the main causes of infertility in women of reproductive age in Ukraine are SSIs after obstetric and gynecological surgeries, and induced abortion. This applies to both primary and secondary infertility group women's in this cohort study.


Assuntos
Endometrite , Infertilidade Feminina , Ooforite , Salpingite , Abscesso , Celulite (Flegmão) , Estudos de Coortes , Feminino , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/etiologia , Infertilidade Feminina/cirurgia , Ooforite/complicações , Gravidez , Salpingite/complicações , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Ucrânia/epidemiologia
5.
Artigo em Chinês | MEDLINE | ID: mdl-35959582

RESUMO

Objective:To summarize the clinical experience in treating children with variant preauricular fistula who present with posterior auricular abscess, and to improve the diagnostic accuracy and therapeutic outcome. Methods:The clinical data of 11 children with preauricular fistula with retroauricular abscess as the main clinical manifestation were analyzed retrospectively. Among them, 10 patients underwent surgical treatment after infection control, and 1 patient underwent preauricular fistula resection during infection period. During the operation, methylene blue was used to trace the fistula, and the fistula and the infected tissue behind the ear were removed as a whole. Follow up regularly after operation. Results:The fistulas of the 11 patients were all located at the helix crus. After the auricular fistula resection with double-incision, the patients were followed up for more than 1 year without recurrence. Conclusion:Children with variant anterior auricular fistula who manifested with postauricular abscess could be successfully managed by Preauricular fistula resection with Double-incision. Careful physical examination before operation and the complete removal of the fistula and the attached cartilage during the operation can avoid misdiagnosis and postoperative recurrence.


Assuntos
Orelha Externa , Fístula , Abscesso/cirurgia , Criança , Anormalidades Craniofaciais , Orelha Externa/cirurgia , Fístula/cirurgia , Humanos , Estudos Retrospectivos , Resultado do Tratamento
6.
Front Immunol ; 13: 923341, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935931

RESUMO

Human brucellosis is one of the most prevalent zoonoses. There are many similarities between the pathogenesis of Mycobacterium tuberculosis (MTB) infection and that of brucellosis. Immune reconstitution inflammatory syndrome (IRIS) may occur during the treatment of MTB infection, but it has not been reported in brucellosis cases thus far. We report the case of a 40-year-old male whose condition initially improved after adequate anti-Brucella therapy. However, 3 weeks later, the patient presented with exacerbation of symptoms and development of a paravertebral abscess. After exclusion of other possible causes of clinical deterioration, immune reconstitution inflammatory syndrome (IRIS) with brucellosis was presumed. After supplementation with anti-Brucella treatment with corticosteroids, the abscess disappeared, and the symptoms completely resolved. Our case suggests that it is necessary to be aware of the possible occurrence of IRIS in patients with brucellosis in clinical practice.


Assuntos
Brucella , Brucelose , Síndrome Inflamatória da Reconstituição Imune , Mycobacterium tuberculosis , Abscesso/patologia , Adulto , Brucelose/complicações , Brucelose/diagnóstico , Brucelose/tratamento farmacológico , Humanos , Síndrome Inflamatória da Reconstituição Imune/diagnóstico , Síndrome Inflamatória da Reconstituição Imune/tratamento farmacológico , Síndrome Inflamatória da Reconstituição Imune/etiologia , Masculino
7.
Korean J Radiol ; 23(8): 785-793, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35914743

RESUMO

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease involving apocrine-bearing sites. It is characterized by recurrent painful nodules and abscesses that potentially rupture, resulting in sinus tract formation, fistulas, and scarring. HS tends to be found in the intertriginous areas (i.e., the axillary, inguinal, and perianal areas of the body). HS may be uncommon for radiologists because its diagnosis is usually based on clinical assessment. However, diagnosis based solely on clinical manifestations can underestimate the severity of HS. Ultrasonography and MRI play a critical adjunct role in determining the severity and extent of the disease and greatly aid its management. Given that MRI is an effective imaging tool, its role in the analysis of severe and anogenital HS lesions merits considerable attention. Unfortunately, anoperineal HS imposes diagnostic dilemmas. It has multiple symptoms and presentations and often mimics other diseases in the intertriginous areas. Therefore, a thorough understanding of HS is essential to avoid delayed diagnoses. This review highlights the typical MRI imaging features and staging of HS, emphasizing on the anoperineal location. The review also differentiates the disease from mimics to facilitate the prompt delivery of appropriate treatment and improve patients' quality of life.


Assuntos
Hidradenite Supurativa , Abscesso , Hidradenite Supurativa/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Dor , Qualidade de Vida
9.
Biomed Res Int ; 2022: 3650213, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35832848

RESUMO

Background: Pelvic abscess surgery consists mostly of open laparotomy and laparoscopic surgery. Open surgery is regarded as a classic procedure. With the rise and promotion of laparoscopic indications in recent years, comparative studies of the two's postoperative effectiveness have been limited. Objective: To compare the clinical effects of laparoscopic exploratory surgery and open surgery in the treatment of pelvic abscess. Methods: Through computer searches of PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases, we found publicly available case-control research on laparoscopic surgery and open surgery for treating pelvic abscess. The papers that met the evaluation criteria were screened, and meta-analysis was used to look at 8 papers on laparoscopic surgery and open surgery for treating pelvic abscess from 2010 to 2021. Results: The results of this study showed that compared with the open laparotomy group, the incidence of laparoscopic group in the incision infection rate (RR = 0.29, 95% CI (0.20, 0.41), and P < 0.00001), the incidence of intestinal injury (RR = 0.08, 95% CI (0.04, 0.14), and P < 0.00001), incidence of intestinal obstruction (RR = 0.26, 95% CI (0.08, 0.90), and P = 0.03 < 0.05), and postoperative pelvic abscess recurrence rate (RR = 0.34, 95% CI (0.13, 0.86), and P = 0.02 < 0.05) are lower than open surgery, and the difference of these four items is statistically significant. There was no difference in the risk of urinary tract injury between laparoscopic surgery and open surgery (RR = 0.92, 95% CI (0.27, 3.17), and P = 0.89 > 0.05). Conclusion: In terms of incision infection, intestinal damage, intestinal obstruction, and recurrence of pelvic abscess, the laparoscopic group clearly outperforms the open group, and it merits clinical promotion and use.


Assuntos
Obstrução Intestinal , Laparoscopia , Abscesso/cirurgia , Colectomia/efeitos adversos , Humanos , Obstrução Intestinal/etiologia , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Laparotomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento
10.
Contrast Media Mol Imaging ; 2022: 5868453, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35833078

RESUMO

Pelvic inflammatory disease refers to a group of infectious diseases of the female upper genital tract, often caused by ascending infection of vaginitis and cervicitis, causing endometritis, salpingitis, tubo-ovarian abscess, pelvic connective tissue inflammation, and/or pelvic peritonitis. PID is the most common and important infectious disease in nonpregnant women of childbearing age, and inflammation in multiple parts often coexists and affects each other. The functional MRI techniques currently used in pelvic floor muscle injury are magnetic resonance diffusion tensor imaging, T2 mapping, and magnetic resonance elastography. Diffusion tensor imaging is a new imaging and postprocessing technology developed on the basis of magnetic resonance diffusion-weighted imaging. Due to the lack of specificity of clinical symptoms, many subclinical patients are often not detected and diagnosed in time, so it is very difficult to accurately estimate the incidence of PID. This article retrospectively analyzed 72 patients with pelvic inflammatory disease confirmed by surgical pathology from February 2020 to 2022, who had undergone pelvic MRI examination before surgery, including 25 patients with chronic pelvic inflammation (hydrosalpinx), 25 patients with acute pelvic inflammation, and 47 cases (including 21 cases of hydrosalpinx, 19 cases of tubo-ovarian abscess, and 7 cases of pelvic abscess). The age range was 13 to 59 years old. The clinical data and MRI findings were analyzed, the ADC value of the cystic part of the lesion was measured, and the differences in age, maximum diameter of the lesion, thickness of the vessel wall/separation, and the ADC value of the cystic part of chronic and acute pelvic inflammation were compared. In this part of the cases, there were 25 cases of chronic pelvic inflammation and 47 cases of acute pelvic inflammation. The average ADC value of the cystic component of chronic inflammation was significantly higher than that of acute inflammation, which were (2.86 ± 0.20) × 10-3 mm2/s and (1.07 ± 0.38) ×10-3 mm2/s, respectively, P value <0.001.


Assuntos
Doença Inflamatória Pélvica , Salpingite , Abscesso/diagnóstico , Adolescente , Adulto , Imagem de Difusão por Ressonância Magnética/métodos , Imagem de Tensor de Difusão , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Doença Inflamatória Pélvica/diagnóstico por imagem , Doença Inflamatória Pélvica/patologia , Estudos Retrospectivos , Salpingite/diagnóstico , Adulto Jovem
11.
BMC Infect Dis ; 22(1): 613, 2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35836203

RESUMO

BACKGROUND: Campylobacter rectus is a gram-negative rod, and Parvimonas micra is a gram-positive coccus, both of which are oral anaerobes that cause chronic periodontitis. Chronic periodontitis can cause bacteremia and systemic diseases, including osteomyelitis. Hematogenous osteomyelitis caused by anaerobic bacteria is uncommon, and to date, there have been no reports of mixed bacteremia with C. rectus and P. micra. Here, we report the first case of osteomyelitis of the femur caused by anaerobic bacteria with mixed bacteremia of C. rectus and P. micra caused by chronic periodontitis. CASE PRESENTATION: A 75-year-old man with chronic periodontitis, hyperuricemia, and benign prostatic hyperplasia was admitted to the hospital with a fracture of the left femur. The patient had left thigh pain for 4 weeks prior to admission. Left femoral intramedullary nail fixation was performed, and a large amount of abscess and necrotic tissue was found intraoperatively. The cultures of abscess specimens were identified as P. micra, Fusobacterium nucleatum, and C. rectus. C. rectus and P. micra were also isolated from blood cultures. C. rectus was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16 S ribosomal RNA sequencing. Sulbactam-ampicillin was administered for approximately 1 month, after which it was replaced by oral clavulanic acid-amoxicillin for long-term suppressive treatment. CONCLUSIONS: Only five cases of bloodstream infection with C. rectus have been reported, and this is the first report of mixed bacteremia with P. micra. Clinicians should consider that chronic periodontitis caused by rare oral anaerobic bacteria can cause systemic infections, such as osteomyelitis.


Assuntos
Bacteriemia , Periodontite Crônica , Osteomielite , Abscesso/complicações , Idoso , Bacteriemia/complicações , Bacteriemia/diagnóstico , Bacteriemia/tratamento farmacológico , Bactérias Anaeróbias , Campylobacter rectus/genética , Periodontite Crônica/complicações , Fêmur , Firmicutes , Humanos , Masculino , Osteomielite/complicações , Osteomielite/tratamento farmacológico , Peptostreptococcus
12.
Comput Intell Neurosci ; 2022: 1405134, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35785101

RESUMO

The purpose of this study was to evaluate the intervention effect of evidence-based nursing (EBN) on vacuum sealing drainage (VSD) recovery of patients with high perianal abscess after vacuum sealing drainage based on magnetic resonance imaging (MRI) sequence images. 60 patients with high perianal abscess were selected, and 30 patients before VSD were selected as the control group. Routine nursing was implemented in the control group, 30 patients after VSD were observed, and EBN was implemented in the observation group. The detection rates of various types of perianal abscess with different sequence combinations were studied, and the effects of EBN on pain and anal function scores of perianal abscess patients were analyzed. Anal function and defecation were assessed, and postoperative complications were calculated. Different combinations of MRI sequences can reach higher detection rates of intersphincter abscess and ischial anal abscess. The observation group had better pain relief and anal function recovery. The complication rate of the observation group was 16.67%, which was significantly lower than that of the control group (P < 0.05). It was confirmed that different MRI sequence combinations had higher detection rates for intersphincter abscess and ischial fossa abscess. EBN can promote the recovery of anal function and reduce complications in patients with perianal abscess.


Assuntos
Abscesso , Tratamento de Ferimentos com Pressão Negativa , Abscesso/diagnóstico por imagem , Abscesso/etiologia , Enfermagem Baseada em Evidências , Humanos , Imageamento por Ressonância Magnética , Dor
13.
Artigo em Inglês | MEDLINE | ID: mdl-35786719

RESUMO

OBJECTIVES: The aim of this retrospective study was to assess the early- and long-term outcomes following the use of cryopreserved allografts in aortic valve endocarditis with peri-annular abscess formation. METHODS: From 2001 to 2021, 110 consecutive patients with active infective endocarditis and peri-annular abscess, underwent a cryopreserved allograft root replacement. In 100 patients (91%), the operation was performed <48 h after admission due to refractory heart failure and or septic shock. In 95 patients (86.4%), a redo operation was performed due to a prosthetic valve endocarditis. Preoperatively, 12 patients were dialysis-dependent and 30 patients suffered from a recent stroke. RESULTS: The 30-day mortality was 18% (20 patients). Freedom from reintervention was 98.3% (standard deviation: 1.7) at 1 year and 83.3% (standard deviation: 8.5) at 10 years. Four patients required a redo operation. Three patients did develop re-endocarditis. Freedom from re-endocarditis was 95% after 17 years of follow-up. Preoperative dialysis dependency (odds ratio: 22.75, 95% confidence interval: 4.79-108.14, P < 0.001), ejection fraction under 30% (odds ratio: 17.91, 95% confidence interval: 3.27-98.01, P < 0.001) and stroke within 14 days prior to operation (odds ratio: 5.21, 95% confidence interval: 1.28-21.2, P = 0.021) were incremental factors associated with the 30-day mortality. CONCLUSIONS: In aortic root endocarditis with abscesses formation, cryopreserved allografts exhibit excellent clinical performance with a low rate of reinfection and reintervention, which make its use as valve replacement a very desirable option. Dialysis dependency, ejection fraction under 30% and recent stroke have the highest impact on the 30-day mortality.


Assuntos
Endocardite Bacteriana , Endocardite , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Acidente Vascular Cerebral , Abscesso/etiologia , Abscesso/cirurgia , Aloenxertos/cirurgia , Valva Aórtica/cirurgia , Valva Aórtica/transplante , Endocardite/cirurgia , Endocardite Bacteriana/cirurgia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Reoperação , Estudos Retrospectivos
14.
Eur Rev Med Pharmacol Sci ; 26(13): 4863-4871, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35856378

RESUMO

OBJECTIVE: Human brucellosis is a zoonosis with an extremely wide spectrum of clinical manifestations. Focal splenic involvement is very uncommon, particularly in the pediatric age group, during the illness' acute phase. CASE REPORT: A 4-year-old boy, already receiving third-generation cephalosporin treatment, was transferred from a local hospital to the University Pediatric Department for fever, anemia, increased inflammation index, and multiple, hyper-echogenic splenic lesions on abdominal ultrasound. Initial diagnostic laboratory investigations for Brucella infection, including the Widal-Wright test, were found to be negative. However, further diagnostic laboratory analysis using the chemiluminescent immunoassay was positive for Brucella IgM antibodies. Treatment with rifampicin at a dose of 150 mg/Kg/twice daily and co-trimethoprim at a dose of 80 mg/Kg/twice daily was started and continued for 7 weeks. IgM antibodies were undetectable after 2 weeks of treatment, and after 6 weeks of treatment, abdominal ultrasound documented a reduction of the diameter of the major splenic infiltrate from 1 to 0.5 cm. At 3 and 5 months of follow-up, re-evaluation of the abdominal lesions displayed complete resolution of the splenic lesions and a complete clinical recovery. CONCLUSIONS: The present case and a literature review are presented in this study since a standard diagnostic laboratory evaluation for brucellosis may miss the diagnosis, and in suspected cases, the laboratory analysis should be extended. Splenic abscesses are known to be rare in brucellosis, but the diagnosis should be considered in children with severe focal lesions, as specific antibiotic treatment may result in complete clinical recovery.


Assuntos
Brucelose , Esplenopatias , Abscesso , Antibacterianos/uso terapêutico , Brucelose/diagnóstico , Brucelose/tratamento farmacológico , Brucelose/patologia , Criança , Pré-Escolar , Humanos , Imunoglobulina M , Masculino , Esplenopatias/diagnóstico por imagem , Esplenopatias/tratamento farmacológico
15.
Am J Case Rep ; 23: e935405, 2022 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-35791273

RESUMO

BACKGROUND Acute appendicitis is by far the most common surgical emergency encountered in the United States and with this in mind, unusual presentations are also frequent, thus improper diagnosis, which roughly occurs in 20-40% of cases, can lead to a delayed treatment and bad outcomes. We present this unusual case of abdominal pain secondary to extraperitoneal compartmentalized abscess following perforated appendicitis, diagnosed and managed as ascites secondary to alcoholic liver cirrhosis with subsequent delay in the treatment of the underlying cause, which was appendicitis. CASE REPORT A 45-year-old man presented to the Emergency Department with pain and distention for 1 week duration, who was treated with frequent paracentesis, with worsening pain following the latest drainage, raising suspicion of perforated viscus. Initial abdominal X-ray and computed tomography (CT) scan revealed free air and large tubular fluid sac collection along the right, left, and lower abdominal wall. Surgical drainage of the abscess was performed. A subsequent follow-up CT with oral contrast of the abdomen revealed perforated right lower abdominal viscus, possible perforated appendicitis with pre-peritoneal and retroperitoneal space occupying the abscess cavity compartmentalized along the right, left, and lower abdominal wall and creating a separate space where the inflammatory purulent material was collected. This was followed by a second procedure for ileocecectomy and ileostomy with excision of the extra-preperitoneal compartment space. CONCLUSIONS Abdominal pain secondary to acute appendicitis is by far the commonest surgical condition; therefore, it should be considered high in the differential diagnosis of any patients presenting with unusual abdominal complaints.


Assuntos
Apendicite , Dor Abdominal/etiologia , Abscesso/diagnóstico , Apendicite/complicações , Apendicite/diagnóstico , Apendicite/cirurgia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos
17.
Neurol India ; 70(3): 1213-1216, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35864669

RESUMO

Background: The radiological features of posteriorly migrated intervertebral discs mimic tumors, hematoma, and abscess. Objective: The aim is to analyze two cases of posteriorly migrated lumbar discs. Cases: Two males had features of cauda equina syndrome. Both had posterior lesions at L4/5 level in magnetic resonance imaging. The mass of the 41-year-old man had peripheral rim enhancement with gadolinium. The epidural mass was excised. The histopathology showed fibrocartilaginous disc. The 67-year-old man had mass with moderate enhancement. The mass had thinned the dura to appear as intradural tumor. The histopathology showed a fibrocartilaginous disc. Immunohistochemistry was negative for neoplasm. Conclusion: A migrated disc should be considered in the case of a posterior extramedullary mass. The granulation tissue around the disc produces peripheral enhancement with gadolinium. Thin enhancement is common. Thick enhancement is also reported. Neoplasms have intense enhancement and inflammatory changes are seen in abscess.


Assuntos
Deslocamento do Disco Intervertebral , Disco Intervertebral , Abscesso/patologia , Adulto , Idoso , Gadolínio , Humanos , Disco Intervertebral/diagnóstico por imagem , Disco Intervertebral/patologia , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Imageamento por Ressonância Magnética/métodos , Masculino
19.
Medicine (Baltimore) ; 101(26): e29761, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35777008

RESUMO

BACKGROUND: Lactational mastitis and breast abscess cause trouble for women. It has been shown that oral probiotics can improve breast microecology, thus alleviating inflammatory responses. Our study aims to understand the long-term effect of Lactobacillus fermentum CECT5716 on patients with lactational breast abscess after needle aspiration. METHODS: Data continued in a randomized controlled study of 101 subjects with lactational abscess from 12 hospitals were included. They were randomly divided into an experimental group and a control group. After needle aspiration treatment, the experimental group was orally administrated with L fermentum CECT5716 for 4 consecutive weeks, while the control group was treated with maltodextrin in the same way). In the third month after randomized controlled trial, the subjects were followed up by an online questionnaire investigation. The observation indexes included the relief of breast pain, recurrence of mastitis from the end of oral administration to the follow-up, and the effect on continuing breastfeeding. RESULTS: A total of 101 patients were enrolled and 83 valid questionnaires were received during follow-up, including 40 in the experimental group and 43 in the control group. The rate of stop breastfeeding due to recurrence of mastitis was 2.5% (1/40) in the experimental group and 18.6% (8/43) in the control group, with a statistically significant difference (odds ratio = 0.112, 95% confidence interval: 0.013-0.942, P < .05). The rate of stop breastfeeding was 10% (4/40) in the experimental group and 25.6% (11/43) in the control group, without significant difference. The pain relief rate in the experimental group was 80% (32/40), which showed no significant difference from that in the control group, that is, 72.1% (31/43). The recurrence rate of mastitis in the experimental group was 20% (8/40), which was not significantly different from that in the control group, that is, 16.3% (7/43). CONCLUSIONS: In lactating women with a history of breast abscess, oral L fermentum CECT5716 may reduce the risk of stop breastfeeding due to recurrence of mastitis.


Assuntos
Empiema Pleural , Lactobacillus fermentum , Mastite , Abscesso/etiologia , Abscesso/terapia , Aleitamento Materno , Empiema Pleural/complicações , Feminino , Seguimentos , Humanos , Lactação/fisiologia , Mastite/terapia
20.
Medicine (Baltimore) ; 101(27): e29732, 2022 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-35801737

RESUMO

Duodenal stump fistula (DSF) is one of the most serious complications of gastrectomy. The mean time to diagnosis of DSF is approximately 9 days after operation. Our report describes an extremely rare case of delayed DSF 144 days after a laparoscopic distal gastrectomy. A 58-year-old man with drug-induced liver cirrhosis (Child-Pugh class A) underwent laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer. On postoperative day 1, he underwent reoperation because of intra-abdominal bleeding. Ongoing bleeding was observed in the stapler line of the duodenal stump and was controlled using metallic surgical clips. The patient was discharged on postoperative day 14, without complications. After 144 days following the first operation, he visited the emergency room with right flank pain and high fever. Computed tomography revealed free air and abscess near the duodenal stump site. Emergency laparotomy, abscess unlooping, and drain insertion were performed. After surgery, bile was drained by intra-abdominal drainage, and fistulography showed a duodenal fistula. The patient was discharged 55 days after his third surgery. This is an extremely rare case of DSF, which may be caused by the metallic surgical clips used for hemostasis of the duodenal stump stapler line. We believe that the use of metallic surgical clips for hemostasis of the duodenal stump after Billroth-II reconstruction should be avoided.


Assuntos
Duodenopatias , Fístula Intestinal , Laparoscopia , Neoplasias Gástricas , Abscesso/cirurgia , Duodenopatias/etiologia , Duodenopatias/cirurgia , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Humanos , Fístula Intestinal/complicações , Fístula Intestinal/cirurgia , Laparoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/cirurgia
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