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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Subphrenic abscess is reported in two patients, one previously operated on for pancreatic carcinoma and the other for clear cell carcinoma of the left kidney. The subphrenic abscess presented with cachexia and low grade fever six months and one year after surgery. Metastatic carcinoma was erroneously diagnosed in both patients. Despite massive antibiotic treatment, both patients succumbed to sepsis. Because of the inherent diagnostic challenge, delineation of a subphrenic abscess in cancer patients without clear-cut evidence of a metastatic spread is crucial.
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PMID:Subphrenic abscess simulating metastatic carcinoma. 47 41

Abscess of the spleen is an uncommon entity that seems even less common as it still represents a diagnostic problem. The most common cause of splenic abscess is metastatic hematogenous seeding of the diseased spleen especially of the infarcted areas or traumatic hematomas. It can result also from the direct spread of infection from surrounding structures. Many patients with splenic abscess have a rapidly progressive generalized sepsis and even the combination of well-timed surgery and antibiotic therapy is not always curative. Local symptoms may be mild and overlooked and there may be only general symptoms of suppuration present. X-rays investigations often yield valuable information about the location of the abscess. By far the most promising technique is splenic scanning with the use of radioisotopes. Our case of splenic abscess following appendicitis has been described. The course and the diagnosis has been established using liver-spleen scanning. The patient was treated with Obracin and Dalacin and the diseased spleen has been removed. After drainage of the left subphrenic abscess the recovery was uneventful.
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PMID:[Spenic abscesses]. 51 22

A 52-year-old man was complicated with a left subphrenic abscess after total pancreatectomy and gastrectomy for advanced pancreatic cancer. A left subphrenic silicon tube penetrated the diaphragm and the bottom of the left lung as well, causing a bronchial fistula with bilateral aspiration pneumonia. Then bronchoscopically, the fistula was successfully treated by packing a few pieces of oxidized cellulose into the affected bronchus. One month later the patient died of sepsis due to multiple liver abscess. On autopsy, the bronchial fistula and any active inflammation were not recognized in the left lower lung area.
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PMID:[Oxidized cellulose occlusion of a peripheral bronchial fistula communicating to the left subphrenic abscess]. 143 99

The effectiveness of intraperitoneal drain was studied on patients undergoing appendicectomy for perforated appendicitis. Randomly 40 patients were allocated with drainage by corrugated rubber drains and 46 patients were without drainage. There were 5 deaths in the series, out of which 4 (10%) were in the drainage group and one (2.2%) in the group without drainage. The incidences of major wound sepsis, paralytic ileus, intraperitoneal abscess and urinary infection were observed in 55%, 42.5%, 12.5% and 15% respectively in drainage group and 50%, 28.3%, 21.7% and 15.2% respectively in non-drainage group. Occurrence of subphrenic abscess (7.5%), burst abdomen (5%) and faecal fistula (5%) were confined to drainage group only.
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PMID:A perforated appendix: should we drain? 152 3

A total of 170 therapeutic biliary drainage procedures were carried out in 90 patients with cancer over a 1-year period (January-December 1988). There were 129 percutaneous transhepatic biliary drainage procedures done in 61 patients and 41 endoprostheses were placed in 29 patients. The overall infection rate related to these procedures was 60.6%, the rate being similar for the two procedures. Infectious complications were experienced by 50% of patients undergoing a biliary drainage procedure. The most common manifestation was cholangitis followed by bacteremia. Other infections included liver abscess, gallbladder abscess, and subphrenic abscess. The most common isolates were enteric gram-negative bacilli, followed by Enterococcus species, Candida species, and Staphylococcus epidermidis. The use of prophylactic antibiotics in 76% of infected patients failed to prevent biliary catheter-related infections. Two patients died of complications related to biliary sepsis. All other infected patients responded to antimicrobial therapy, which included various regimens of beta-lactam agents (third-generation cephalosporin, extended-spectrum penicillin, imipenem-cilastatin, and aztreonam) that were used in combination with an aminoglycoside in 15 patients.
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PMID:Infections associated with biliary drainage procedures in patients with cancer. 192 74

Montpellier Cancer Institute strategy and experience in surgical treatment of multi-bilateral hepatic metastases from digestive tract cancers is presented based on retrospective case by case analysis of survival time of 38 patients. The mean age was 46.2 years and the primaries were colorectal (22 patients) and endocrine (16 patients). Liver surgery was synchronous to the resection of primary lesions in 8 patients and metachronous in 22 patients. Two-step liver surgery was performed in 8 patients. Overall thirty-days postoperative mortality was 7.8% and morbidity 15.7% (wound sepsis, subphrenic abscess, transitory jaundice, biliary fistula). The analysis of survival time evidenced that with reasonable risk-benefit ratio the aggressive surgical approach can be justified especially in patients with endocrine primaries.
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PMID:Montpellier Cancer Institute strategy and experience in surgical treatment of multi-bilateral hepatic metastases from digestive tract cancers. 224 18

From 1978 to 1987, thirty patients were secondarily referred to Saint-Antoine Hospital for the treatment of their hepatic trauma. Seventeen were referred because of a postoperative complication (group I) and thirteen after peri-hepatic packing (group II). In group I, transfer was decided because of hemorrhage (8 patients), sepsis (6 patients) and haemobilia (3 patients). The lesions observed in this group (hemoperitoneum, hepatic sequestrum, intrahepatic hematoma, choleperitoneum and subphrenic abscess) were often related to an incomplete assessment of hepatic damage due to an inadequate exploration and the absence of operative cholangiography. In group II, peri-hepatic packing was effective in eleven patients. The overall mortality was 16.6% (17.6% in group I and 15.4% in group II). Postoperative complications occurred in 50% of the patients (64.6% in group I and 30.7% in group II). Good exposure of the liver, operative cholangiography and, in selected cases, a direct approach to the lacerated liver with suture ligation of severed blood vessels and bile ducts are mandatory for the complete exploration and the treatment of severe hepatic trauma. Peri-hepatic packing and the transfer of the patient to a specialized center is a reliable method when the injury cannot be treated locally.
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PMID:[Reoperation in severe hepatic trauma. 30 cases]. 227 Sep 18

Subphrenic omental bursa abscess is frequently overlooked and the overall mortality is 70%. Early diagnosis and drainage improve the prognosis considerably. In cases with abdominal symptoms followed by pyrexia, possibly with signs of sepsis, and pleural effusion but with no or only slight findings on objective clinical examination, subphrenic abscess should be suspected and a scanning of the abdomen should be performed.
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PMID:[Abscess of the omental bursa (lesser sac)]. 232 Dec 87

Thirteen patients with abdominal trauma who developed abdominal sepsis resistant to conventional methods of reexploration and drainage were managed by an open method. Eleven of these patients had multiorgan failure. The extent of anatomic and physiologic injury was defined by Abdominal Trauma Index and Acute Physiology and Chronic Health Evaluation (APACHE) scores, respectively. Ten of the 13 patients (76.9%) survived, a significantly improved survival as compared with that predicted by APACHE (50%). Complications attributable to the open technique (enteric fistula and a subphrenic abscess) occurred in two of the ten survivors. It is concluded that the open method of management of abdominal sepsis is effective and feasible. It should be considered in patients with necrotizing wound infections, multiorgan failure, and ongoing abdominal sepsis uncontrolled by conventional methods. Larger, controlled series employing such systems as the APACHE are needed for a better definition of patient selection for the open method.
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PMID:Open management of the posttraumatic septic abdomen. 239 97

Although the first Aeromonas strain was described by Zimmermann as early as in 1890, it took 60 years until Caselitz established human pathogenicity of strains then called "Vibrio jamaicensis". Since then, and especially in the last 10 years, there have been increasing numbers of reports on different infections caused by members of the genus Aeromonas. These include sepsis; meningitis; cellulitis; necrotizing fasciitis; ecthyma gangrenosum; pneumonia; peritonitis; conjunctivitis; corneal ulcer; endophthalmitis; osteomyelitis; suppurative arthritis; myositis; subphrenic abscess; liver abscess; cholecystitis and/or ascending cholangitis; urinary tract infection; endocarditis; ear, nose, and throat infections; balanitis; etc. The role of Aeromonas in gastrointestinal disease is very controversial. Increasing epidemiological data suggest that these organisms play a major role in enteric infections, but so far enteropathogenicity has not been demonstrable in experiments where volunteers were given high numbers of Aeromonas possessing different virulence factors. Virulence factors include hemolysin(s), enterotoxin(s), hemagglutinins, invasivity, and others; but these are not found more frequently in strains isolated from patients with diarrhea than from healthy controls. Whether there is a correlation between species and disease remains to be elucidated and requires more information about the taxonomy of this genus.
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PMID:Aeromonas as a human pathogen. 264 16


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