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

In a group of 260 non-selected cases of acute or subacute pancreatitis, severe complications occurred in 60 (23.1%). Long lasting shock and/or massive internal bleeding (5.4%), severe renal problems (anuria, tubular necrosis, nephrosis) (5.4%) and frank hepatic failure due to extensive liver necrosis or other severe destruction (5.0%), invariably lead to death. The clinical group of findings pointing to a fatal course usually manifested themselves during the first three days. Severe renal and hepatic lesions were in many cases secondary to shock in fulminant rapidly deteriorating cases. Preventing and efficient management of shock are thus essential prerequisites for saving the patient. Other important complications included severe intra-abdominal suppuration and abscesses, peritonitis and sepsis (3.9%), pseudocysts of the pancreas (5.4%) and biliary statis (18.4%). Severe obstruction to bile flow with associated jaundice occurred in only 4.6% of cases; unselected operative biliary decompression does not therefore appear indicated. If an early laparotomy is performed, efficient debridement and drainage are of utmost importance. Fatal panreatitis was associated with extensive necrosis of the pancreas in about 80% of cases; possibly subtotal pancreatic resection at an early laparotomy would have given better results in these most severe cases, as recently reported in the literature.
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PMID:Complications in acute pancreatitis. 103 80

Anesthetic-induced immunosuppression, if clinically significant, could modify the natural course of infectious disease in vivo. To test this bypothesis, the localized response to IM Candida albicans and the mortality following fecal peritonitis were examined in anesthetized mice. Using these 2 models, halothane anesthesia was found not to modify the natural history of local sepsis but to significantly accentuate the mortality associated with the more severe infection. Possible explanations for these results include significant inhibition of reticuloendothelial function or plasma opsonization with relatively minor derangements of peripheral leukocyte capability.
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PMID:Anesthesia and the modification of response to infection in mice. 103 91

Jaundice developing in critically ill or injuried patients should probably be thought of as a manifestation of severe sepsis until proven otherwise. Septic jaundice occurs in about 50 to 60 per cent of patients with generalized peritonitis. Biochemically, jaundice associated with bilirubin (particularly the direct fraction) and liver enzymes (particularly the alkaline phosphatase) and a decrease in the serum albumin. Histologically there is intrahepatic cholestasis. The etiology of these changes in unknown, but they appear to be due to an end organ response to sepsis. Optimal treatment involves control of the sepsis and maintenance of a glood flow of well-oxygenated blood to the liver.
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PMID:Hepatobiliary complications of sepsis. 104 57

In a group of 260 non-selected cases of acute or subacute pancreatitis, severe complications occurred in 60 (23.1%). Long lasting shock and/or massive internal bleeding (5.4%), severe renal problems (anuria, tubular necrosis, nephrosis) (5.4%) and frank hepatic failure due to extensive liver necrosis or other severe destruction (5.0%), invariably lead to death. The clinical group of findings pointing to a fatal course usually manifested themselves during the first three days. Severe renal and hepatic lesions were in many cases secondary to shock in fulminant rapidly deteriorating cases. Prevention and efficient management of shock are thus essential prerequisites for saving the patient. Other important complications included severe intra-abdominal suppuration and abscesses, peritonitis and sepsis (3.9%), pseudocysts of the pancreas (5.4%) and biliary stasis (18.4%). Severe obstruction to bile flow with associated jaundice occurred in only 4.6% of cases; unselected operative biliary decompression does not therefore appear indicated. If an early laparotomy is performed, efficient debridement and drainage are of utmost importance. Fatal pancreatitis was associated with extensive necrosis of the pancreas in about 80% of cases; possibly subtotal pancreatic resection at an early laparotomy would have given better results in these most severe cases, as recently reported in the literature.
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PMID:Complications in acute pancreatitis. 108 10

Phlegmonous colitis, regarded as a terminal event in serious liver disease and hepatic coma, can also occur in reversible liver disease and can be the source of gram-negative sepsis. This paper presented such a case. Improved management of serious liver disease and hepatic coma should include consideration of colonic inflammation as another site of infection that must be treated to avoid complications of sepsis or peritonitis. Abdominal pain and loose or diarrheal stools should arouse a suspicion of the presence of phlegmonous colitis, and should be an indication for treating it and preventing sepsis.
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PMID:Liver disease, phlegmonous colitis, and gram-negative sepsis. 109 83

A method of intra- and postoperative antibiotic peritoneal lavage, using 0.015% gentamicin in dialysis solution, has been assessed for the treatment of life-threatening peritonitis. It is believed to be the first time that the use of gentamicin for this purpose has been recorded, and the first time that antibiotic peritoneal lavage has been used for the treatment of a series of patients with peritonitis of gynaecological or obstetrical origin. At Baragwanath Hosital, gynaecological patients with life-threatening purulent peritonitis arising from septic abortions, tubal sepsis (ruptured pyosalpinx) or postoperative causes, were studied. Thirty-eight such patients undergoing standard operative treatment had a mortality of 47.4%, which is in accordance with world figures for serious peritonitis. In 38 patients, after the addition of antibiotic peritoneal lavage, mortality was halved to 2397%, with minimal morbidity. The procedure used has been fully described, and is recommended for wider trial in patients with life-threatening peritonitis or peritoneal soiling.
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PMID:Antibiotic peritoneal lavage in severe peritonitis. A preliminary assessment. 111 14

A successfully treated case of acute fulminating necrotizing amebic colitis characterized by signs of toxemia, septicemia and peritonitis is reported. Early diagnosis and staged surgical procedures apparently lower the mortality. Intensive antiamebic therapy should be instituted as soon as amebiasis is confirmed, otherwise surgical therapy is likely to fail.
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PMID:Massive necrosis and perforation of the colon in amebiasis. 114 96

A serious complication following the insertion of an IUD is perforation of the uterus and translocation of the device into the abdominal cavity. Uterine perforation can be divided into "primary" ones, the most common, which are related to the insertion procedure, and "secondary" ones, which are caused by uterine contractions. A rare type of secondary perforation is to the broad ligament. Heretofore, only 4 such cases have been reported. 2 additional cases, occurring with the Dalkon shield, are reported here. Although the translocation of an IUD into the leaves of the broad ligament is rare, this complication should be considered whenever an IUD cannot be removed by pulling the strings. 2 possible complications--rupturing of the uterine vessels causing serious intraabdominal bleeding and infection, with potential danger of peritonitis and sepsis--could greatly endanger the patient's life. The 2 cases reported here were resolved satisfactorially.
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PMID:Translocation of the Dalkon Shield into the broad ligament. 117 20

The onset of infective phenomena following abdominal surgical operations requires a full assessment based on the danger of septic intraperitoneal focus, which can only be cured by surgery. The indications for re-operation depend on the presence, or absence, of two types of symptom: Firstly, the existence of local signs, such as peritonitis, intestinal obstruction, whether clinically or on XRay. Furthermore, the onset of general signs, such as septicemia, septic shock, acute organic renal failure, or interstitial pneumonia, may lead to re-operation, even in the absence of local abdominal signs, provided one has eliminated any obvious extra-peritoneal septic focus.
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PMID:[Indications for re-operation for infectious complication of abdominal surgery]. 119 86

Analysis of prosector's findings and results of pathoanatomical studies of 65 cases who had died from sepsis showed that its incidence increased from 0.92% in 1956--1960 to 4.11% in 1971-1974. Along with the well-known typical manifestations of sepsis, a number of its perculiar features associated with application of modern therapeutic methods are considered: the prevailing form of sepsis is pyemia (81.5%), considerable incidence of sepsis following peritonitis and septic thrombophlebitis developing at sites of prolonged catheterization of veins. The significance of staphylococci and Bacillus pyocyaneus, which are resistant to the majority of the available at present antibiotics, as principle pathogenes of modern sepsis is emphasized. A dependence between the localization and size of metastatic foci and the kind of pathogene and nature of its toxines is noted. Among the conditions contributing to the development of sepsis the authors consider a reduction of the immunological reactivity of the organism morphologically characterized in the dead persons studied by the absence in lymphatic follicles of lymphatic nodes and the spleen, of "light" centres, drastic atrophic changes in the thymus gland in the majority of cases, and by slightly manifested phenomena of phagocytosis of microbes in the foci of inflammation. The role of operative and other traumas, the character of preceding diseases and application of immunodepressive therapy in the reduction of the immunological reactivity of the organism is tressed.
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PMID:[Pathological anatomy of present-day sepsis]. 120 Aug 80


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