Risk factors for liver abscess formation in patients with blunt hepatic injury after non-operative management

Abstract Background There is a controversy about the management of patients with a thoracolumbar burst fracture. Despite the success of the conservative treatment in most of the cases, some patients failed the conservative treatment. The present study aimed to evaluate risk factors for the need for surgery during the follow-up period in these patients. Methods We retrospectively evaluated 67 patients with a traumatic thoracolumbar burst fracture who managed conservatively at our center between May 2014 and May 2019. Suggested variables as potential risk factors for the failure of conservative treatment including age, gender, body mass index (BMI), smoking, diabetes, vertebral body compression rate (VBCR), percentage of anterior height compression (PAHC), Cobb angle, interpedicular distance (IPD), canal compromise, and pain intensity as visual analog scale (VAS) were compared between patients with successful conservative treatment and those with failure of non-operative management. Results There were 41 males (61.2%) and 26 females (38.8%) with the mean follow-up time of 15.52 ± 5.30 months. Overall, 51 patients (76.1%) successfully completed conservative treatment. However, 16 cases (23.9%) failed the non-operative management. According to the binary logistic regression analysis, only age (risk ratio [RR], 2.21; 95% confidence interval [95%], 1.78–2.64; P = 0.019) and IPD (RR 1.97; 95% CI 1.61–2.33; P = 0.005) were the independent risk factors for the failure of the non-operative management. Conclusions Our results showed that older patients and those with greater interpedicular distance are at a higher risk for failure of the conservative treatment. As a result, a closer follow-up should be considered for them.

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Abstract No. 150: Non Operative Management of Blunt Trauma to the Liver by Transcatheter Embolization: Risk Factors for Late Rebleeding

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2008.12.135 ◽

2009 ◽

Vol 20 (2) ◽

pp. S58-S59

Author(s):

H.M. Richard ◽

S. Atluri ◽

K. Shanmuganathan ◽

D. Stein ◽

D.M. Widlus ◽

...

Keyword(s):

Risk Factors ◽

Blunt Trauma ◽

Transcatheter Embolization ◽

Operative Management ◽

Non Operative Management

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Penatalaksanaan kegawatdaruratan bidang urologi; priapismus

Wellness And Healthy Magazine ◽

10.30604/well.83212020 ◽

2020 ◽

Vol 2 (1) ◽

pp. 171-176

Author(s):

Ardina Marista

Keyword(s):

Risk Factors ◽

Erectile Dysfunction ◽

Drug Use ◽

Sickle Cell ◽

Sickle Cell Anemia ◽

Sexual Desire ◽

Operative Management ◽

Neoplastic Syndromes ◽

Blood Aspiration ◽

Non Operative Management

Priapism is an erection of the penis for more than 4 hours without accompanying sexual desire. Priapism is a urology emergency whose complications are erectile dysfunction. Risk factors for Sickle cell anemia, drug use, neoplastic syndromes, trauma, hemodialysis, infection (malaria), toxins (scorpion bites, spiders, neurogenic conditions in perioperative patients under the influence of anesthetics. Priapism is divided into two types, ischemic type (95) %), and non-ischemic type (5%). Management is in the form of operative and non-operative management. In ischemic type non-operative management is in the form of blood aspiration in penile corpora (using 16-18Fr abocath in directions 10 and 2, away from bundle neuravascular complexes (in the direction of at 12 o'clock and urethra towards 6 o'clock), aspiration until bright red blood is found. In the non-ischemic type this therapy is considered to have no effect. Non-ischemic type is not an emergency, the treatment in the form of ice compresses in the perineum.In severe circumstances operative management is required in the form of techniques penile shunt.

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Fusobacterium Nucleatum : An Atypical Cause of Pyogenic Liver Abscess in an Apparently Immunocompetent Patient

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v20i1.1769 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Yusoff AR ◽

Abd Razak NA ◽

Samsuddin S ◽

Mokhtar S

Keyword(s):

Liver Abscess ◽

Percutaneous Drainage ◽

Fusobacterium Nucleatum ◽

Pyogenic Liver Abscess ◽

Enteric Bacteria ◽

Operative Management ◽

Immunocompetent Patient ◽

Immunocompromised Status ◽

Anaerobic Infections ◽

Non Operative Management

Pyogenic liver abscess is an uncommon but potentially lethal infection if left untreated. Enteric bacteria and anaerobes are the most common causative organisms of pyogenic liver abscess. Although most infections are of a polymicrobial nature, monomicrobial infections are possible. An immunocompromised status and the presence of periodontal disease are the risk factors for liver abscess caused by these rare, monomicrobial anaerobic infections. Here, we report on a successful non-operative management of a case of multiloculated pyogenic liver abscess caused by Fusobacterium nucleatum in a young, healthy, immunocompetent male patient. The diagnosis was established by radiological imaging and was based on a positive aspirate culture, whereas the mainstay of treatment comprised percutaneous drainage and a prolonged course of antibiotics. Thus, the patient was successfully treated with a 2-week course of intravenous imipenem/cilastatin while he was on percutaneous drainage, and he is now doing well.

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