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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Colonic necrosis is a rare complication of peripancreatic sepsis following acute pancreatitis. Three patients with colonic necrosis associated with extensive retroperitoneal suppuration are reported. The pathogenesis of this syndrome may be explained by the tendency of pancreatic abscesses to extend widely in the retroperitoneum. Management is discussed, emphasizing the need for an aggressive surgical approach and multiple operations.
Dis Colon Rectum 1985 Dec
PMID:Colonic necrosis in acute pancreatitis. A complication of massive retroperitoneal suppuration. 406 56

In a prospective randomized clinical trial, 103 patients undergoing elective colorectal surgery received either cefoxitin or a combination of metronidazole and gentamicin. Six of 52 patients in the cefoxitin group (11.5 per cent) and six of 48 patients in the metronidazole/gentamicin group (12.5 per cent) developed serious wound infections. Two patients (3.8 per cent) in the cefoxitin group and one patient (2.1 per cent) in the metronidazole/gentamicin group developed deep sepsis. These results suggest that cefoxitin is as effective as the combination of metronidazole and gentamicin for prophylaxis against serious postoperative septic complications.
Dis Colon Rectum 1983 Oct
PMID:A comparison of intravenous cefoxitin and a combination of gentamicin and metronidazole as prophylaxis in colorectal surgery. 634 50

Rectal abscess may result in necrotizing soft-tissue infection including fasciitis, myositis, and extraperitoneal dissection of pus without muscle necrosis. The presentation and therapy of ten patients treated over the past six years are reviewed. Early recognition of rapidly spreading infection was imperative. The mortality rate of 40 per cent correlated with the degree of sepsis present at admission. The high mortality attendant with the complications of rectal abscess emphasizes the need for aggressive therapy, including frequent examinations under anesthesia, wide debridement, systemic triple antibiotic therapy, diverting colostomy, aggressive wound care, and hyperalimentation.
Dis Colon Rectum 1983 Aug
PMID:Necrotizing soft-tissue infection from rectal abscess. 640 68

Forty-four patients with enterocutaneous fistulas treated at the University of Nigeria Teaching Hospital (UNTH) Enugu in five years (1977-81) are reviewed. Most fistulas resulted from complications of surgery (29 per cent) and appendicitis (55 per cent). The commonest locations were in the cecum (48 per cent), ileum (30 per cent), and colon (20 per cent). The outstanding complication was sepsis. Spontaneous closure occurred in 15 patients (34 per cent). Twenty-two patients were treated surgically. There was a high mortality of 18 per cent from septic complications and malnutrition.
Dis Colon Rectum 1984 Aug
PMID:Enterocutaneous fistulas in Enugu, Nigeria. 646 92

The consequences of pelvic sepsis after Ivalon rectopexy are described in four patients. Despite clear evidence of pelvic infection, reoperation was delayed by ineffective conservative measures and morbidity thereby prolonged. In three, the causative organism was Staphylococcus aureus and it is suggested that prophylactic antimicrobial regimens for intestinal organisms alone may be inadequate.
Dis Colon Rectum 1984 Sep
PMID:Management of pelvic sepsis after Ivalon rectopexy. 646 97

We report the results of a prospective audit of the rates of postoperative infection in patients having operations for inflammatory bowel disease. Apart from a single prospective controlled trial, all other groups have been studied sequentially using the original placebo control group for comparison. The rate of abdominal wound sepsis when no antibiotic was used was 37 per cent. This was reduced to 23.3 per cent with 24-hour cover using metronidazole and gentamicin. However, only after prolonged use of metronidazole and gentamicin for five days was there a significant reduction in abdominal wound infections to 13.3 per cent. Prophylaxis, using 24-hour cover with metronidazole combined with five-day therapy with mezlocillin, achieved an abdominal wound infection rate of 15.6 per cent. The most recent group of patients studied have received 24-hour cover with metronidazole and five-day exposure to latamoxef. In the last group the rate of abdominal wound infections was only 13.5 per cent and serious postoperative bleeding was recorded in eight patients (15 per cent) compared with serious bleeding is only three of the remaining 129 patients (2.3 per cent). The only patients in whom streptococcal isolates were eliminated were those receiving metronidazole and mezlocillin. The majority of infections was due to antibiotic-sensitive strains of Escherichia coli, Proteus, and Staphylococcus species.
Dis Colon Rectum 1984 Sep
PMID:Audit of sepsis in operations for inflammatory bowel disease. 646 1

Concentrations of ampicillin after intraincisional instillation in laparotomy wounds were measured in ten patients undergoing appendectomy. Ampicillin, 1 gm, was instilled under the fascia and 1 gm in the subcutaneous space during wound closure. Wound secretion was collected every two hours during the first 24 postoperative hours by cannulation of a fine perforated drain placed in the subcutaneous space. Ampicillin was determined by a disk diffusion method. During the first eight hours the median concentration of ampicillin in wound secretion exceeded 1000 microgram/ml; 14 hours and 20 hours after wound closure the median concentrations were 73 and 14 microgram/ml, respectively. The effect of ampicillin in high concentrations on "resistant" strains of Bacteroides fragilis was demonstrated in an in vitro experiment. It is concluded that in colorectal surgery the effect on wound sepsis of intraincisional antibiotics as an addition to systemic antibiotic prophylaxis should be evaluated in a clinical trial.
Dis Colon Rectum 1984 Mar
PMID:Intraincisional antibiotics in laparotomy wounds. 655 66

Nontraumatic Clostridium septicum infections may present as either septicemia or as metastatic myonecrosis. Most of these infections occur in debilitated patients with diabetes who are receiving cancer chemotherapy. The majority have a hematologic abnormality or a carcinoma of the colon. Usually there is an ulcerative lesion of the gastrointestinal tract that serves as the portal of entry. While most of these patients die from overwhelming sepsis, our patient was debrided early and treated promptly with high-dose penicillin therapy as well as hyperbaric oxygen therapy. He fully recovered from C. septicum gas gangrene and underwent resection of a recurrent colonic cancer.
Dis Colon Rectum 1983 Nov
PMID:Nontraumatic Clostridium septicum gangrenous myonecrosis. 662 41

Over a three-year period, 1980-82, 79 per cent of our patients with rectal cancer were treated with the intention of cure, and sphincter-saving procedures were performed in 62 per cent of these cases. This report concerns 21 patients with mid-rectum cancer operated on with low anterior resection and extraperitoneal EEA-stapled anastomosis. Nine patients had Dukes' stage A tumors, seven had stage B, and five had stage C tumors. An 86-year-old woman died in the sixth postoperative week, and a 74-year-old man died after 20 months with a probable recurrence. Nineteen patients are currently alive 4 to 40 months post-operatively, with no overt signs of recurrence. We cannot confirm recent alarming reports on a significant incidence of early local recurrence. Routine Gastrografin enemas were performed and offered very little in terms of clinical guidance. Significant anastomotic leakage occurred in four patients, although without clinical symptoms or the need for fecal diversion. Despite initially intact anastomoses in 13 patients, pelvic sepsis with late dehiscence developed in three, all of whom required fecal diversion. The clinical leak rate was thus 3 of 21, 14 per cent, and the total incidence of leakage 7 of 21, 33 per cent. We performed routine colostomy on the first three patients but, in retrospect, believe this was unneccessary. Only one of the 19 survivors still has a colostomy, due to a benign anastomotic stricture. We consider anterior resection of mid-rectum carcinoma with EEA-stapled anastomosis a highly feasible procedure, the curative potential of which, however, can be established only by long-term follow-up studies.
Dis Colon Rectum 1983 Dec
PMID:EEA stapler for mid-rectum carcinoma. Review of recent literature and own initial experience. 664 59

Colonic resections, particularly those that require mobilization of the splenic flexure, occasionally will lead to injury of the spleen. Under these circumstances, the abdominal surgeon has traditionally considered incidental splenectomy to be the only safe alternative. Currently, a better understanding of splenic physiology and its role in sepsis prevention has reversed this trend. These efforts to preserve splenic function have resulted in various options available to the surgeon, herein reviewed. The results obtained in 36 general surgical patients with splenic injuries suggest that the salvage of the spleen is a safe alternative. In situations where salvage is impossible, the surgeon can resort to omental autotransplantation of the removed spleen, a recently described technique of appealing simplicity. The results obtained with this procedure in 23 other patients are presented.
Dis Colon Rectum 1984 Jan
PMID:Colonic surgery. The splenic connection. 669 Feb 63


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