scholarly journals Abdominal Sepsis: An Update

2018 ◽  
Vol 4 (4) ◽  
pp. 120-125 ◽  
Author(s):  
Mircea Gabriel Mureșan ◽  
Ioan Alexandru Balmoș ◽  
Iudita Badea ◽  
Ario Santini
Keyword(s):  
Antibiotic Therapy ◽  
Early Recognition ◽  
Abdominal Cavity ◽  
Abdominal Sepsis ◽  
Prognostic Scores ◽  
Significant Development ◽  
Surgical Measures ◽  
Life Threatening ◽  
Intra Abdominal Infection ◽  
Abdominal Infections

Abstract Despite the significant development and advancement in antibiotic therapy, life-threatening complication of infective diseases cause hundreds of thousands of deaths world. This paper updates some of the issues regarding the etiology and treatment of abdominal sepsis and summaries the latest guidelines as recommended by the Intra-abdominal Infection (IAI) Consensus (2017). Prognostic scores are currently used to assess the course of peritonitis. Irrespective of the initial cause, there are several measures universally accepted as contributing to an improved survival rate, with the early recognition of IAI being the critical matter in this respect. Immediate correction of fluid balance should be undertaken with the use of vasoactive agents being prescribed, if necessary, to augment and assist fluid resuscitation. The WISS study showed that mortality was significantly affected by sepsis irrespective of any medical and surgical measures. A significant issue is the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in the clinical setting, and the reported prevalence of ESBLs intra-abdominal infections has steadily increased in Asia. Europe, Latin America, Middle East, North America, and South Pacific. Abdominal cavity pathology is second only to sepsis occurring in a pulmonary site. Following IAI (2017) guidelines, antibiotic therapy should be initiated as soon as possible after a diagnosis has been verified.

scholarly journals Intramural hematoma in the jejunum as a cause of colics in horses

2017 ◽  
Vol 73 (10) ◽  
pp. 671-674
Author(s):  
Bernard Turek ◽  
Roma Buczkowska ◽  
Bartłomiej Obrochta ◽  
Kamil Górski ◽  
Olga Drewnowska
Keyword(s):  
Small Intestine ◽  
Antibiotic Therapy ◽  
Fluid Therapy ◽  
Abdominal Cavity ◽  
Intramural Hematoma ◽  
Physiological Solution ◽  
Postoperative Treatment ◽  
Full Health ◽  
Life Threatening ◽  
Severity Of The Disease

Colics in horses are a common problem, which can be life-threatening for the animal, depending on the type and severity of the disease. The case described in this article concerns surgically treated intramural hematoma of the jejunum in a 3-year-old Arabian mare. Medial laparotomy was performed in dorsal recumbency under general anesthesia. During the exploration of the abdominal cavity, highly filled intestinal loops were found along with intramural hematoma located in the jejunum. A resection of the intestinal part with extravasation was performed, and the content of the small intestine was evacuated. The postoperative treatment consisted of intravenous and general antibiotic therapy as well as intensive fluid therapy for the next 5 days. The abdominal cavity was flushed two times a day with a warm physiological solution containing heparin. After 3 days the drain was removed. After the treatment the mare returned to full health.

SURGICAL TREATMENT STRATEGY FOR COMMON PERITONITIS IN THE ELDERLY PATIENTS

2021 ◽  
pp. 1186-1192
Author(s):  
Б. В. Сигуа ◽  
В. П. Земляной ◽  
С. В. Петров ◽  
В. А. Игнатенко ◽  
П. А. Котков
Keyword(s):  
Abdominal Cavity ◽  
Treatment Algorithm ◽  
Age Groups ◽  
Postoperative Mortality ◽  
The Elderly ◽  
Abdominal Sepsis ◽  
Adverse Outcomes ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Intra Abdominal Infection

Несмотря на очевидный прогресс в изучении вопросов лечения распространенных форм вторичного перитонита, ближайшие результаты далеки от удовлетворительных, в особенности у больных старших возрастных групп. В ряде случаев однократного оперативного вмешательства оказывается недостаточно для полноценной санации источника внутрибрюшной инфекции, что побуждает к проведению повторных санационных вмешательств, порядок и сроки выполнения которых на настоящий момент не являются строго регламентированными. Изучена эффективность применения лечебного алгоритма, подразумевающего дифференцированный подход к проведению плановых хирургических санаций в краткие сроки у больных с выраженными патоморфологическими изменениями в брюшной полости. Результаты лечения больных с применением плановых санационных вмешательств продемонстрировали эффективность разработанного алгоритма, позволив снизить общую послеоперационную летальность за счет сокращения удельного веса абдоминального сепсиса в структуре неблагоприятных исходов. Despite the obvious progress in the treatment of secondary peritonitis common forms, the results are far from satisfactory, especially among patients of older age groups. In some cases, a single surgical intervention is not enough for a complete elimination of the intra-abdominal infection source, which leads to repeated sanitation interventions, the order and timing of which are currently not strictly regulated. The effectiveness of the treatment algorithm, which considers a differentiated approach to planned surgical interventions in a short time in patients with severe pathomorphological changes in the abdominal cavity, was studied. The results of treatment using planned sanitation interventions demonstrated the effectiveness of the developed algorithm, allowing to reduce the overall postoperative mortality by reducing the proportion of abdominal sepsis in the structure of adverse outcomes.

scholarly journals A Rare Case of Pylephlebitis as a Complication of Cholecystocolonic Fistula

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Kouki Imaoka ◽  
Saburo Fukuda ◽  
Hirofumi Tazawa ◽  
Sotaro Fukuhara ◽  
Yuzo Hirata ◽  
...  
Keyword(s):  
Portal Vein ◽  
Vein Thrombosis ◽  
Anterior Branch ◽  
Life Threatening ◽  
Cholecystocolonic Fistula ◽  
Intra Abdominal Infection ◽  
Upper Abdominal ◽  
Abdominal Infections ◽  
High Index Of Suspicion ◽  
Enhanced Computed Tomography

Pylephlebitis is defined as a septic thrombophlebitis of the portal vein and its tributaries that is associated with multiple suppurative abdominal infections. We report a case of pylephlebitis associated with a cholecystocolonic fistula (CCF). A 41-year-old man presented with upper abdominal pain and anorexia for 1 month. Abdominal contrast-enhanced computed tomography (CT) revealed thrombosis in the left and anterior branch of the portal vein and thickening of the walls of the portal vein and periside portals. The gallbladder was collapsed and pneumobilia was seen in the biliary tract. Blood culture was positive for Streptococcus anginosus. A diagnosis of thrombophlebitis of the portal vein associated with CCF was made, and the patient was immediately managed with an intravenous broad-spectrum antibiotic and anticoagulation. After the portal vein thrombosis (PVT) propagation and inflammation had subsided, cholecystectomy and partial resection of the transverse colon were performed. Pylephlebitis is rare but is a life-threatening complication of intra-abdominal infection. A high index of suspicion is required, and a CT scan should be performed immediately for an early diagnosis and appropriate treatment.

Intra-abdominal sepsis in the critically ill

2016 ◽  
Author(s):  
Jeffrey D. Doyle ◽  
John C. Marshall
Keyword(s):  
Critically Ill ◽  
Anaerobic Bacteria ◽  
Abdominal Sepsis ◽  
Source Control ◽  
Successful Management ◽  
Abdominal Infection ◽  
Infectious Disease Specialists ◽  
Intra Abdominal Infection ◽  
Abdominal Infections ◽  
Prompt Diagnosis

Intra-abdominal infection encompasses a broad group of infections arising both within the peritoneal cavity and the retroperitoneum. The probable bacteriology reflects patterns of normal and pathological colonization of the gastrointestinal tract. Anaerobic bacteria are found in the distal small bowel and colon. The abdomen is the second most common site of infection leading to sepsis in critically-ill patients. Intra-abdominal infections can be complex to manage and require excellent collaboration between intensivists, diagnostic and interventional radiologists, surgeons, and sometimes gastroenterologists and infectious disease specialists. Prompt diagnosis, appropriate antimicrobial coverage and timely source control are the cornerstones of successful management. The spectrum of pathologic conditions responsible for intra-abdominal infection is broad, although some common biological features facilitate an understanding of their diagnosis and management.

How serious are oral infections?

2004 ◽  
Vol 118 (7) ◽  
pp. 561-565 ◽  
Author(s):  
Zaid H. Baqain ◽  
Laurence Newman ◽  
Nicholas Hyde
Keyword(s):  
Antibiotic Therapy ◽  
Head And Neck ◽  
Soft Tissues ◽  
Early Recognition ◽  
Surgical Drainage ◽  
Intravenous Antibiotic ◽  
Oral Infections ◽  
The World ◽  
Life Threatening ◽  
Dental Infections

Life-threatening conditions following dental infections have been rare since antibiotics were introduced into the world of medicine. However, infections spreading through the soft tissues of the head and neck are encountered occasionally and mortality is still reported as a result of sepsis or airway embarrassment. A case of Ludwig’s angina from odontogenic infection that progressed into mediastinitis and pericarditis is presented. The steps adopted in the management of this case highlight the significance of early recognition and diagnosis of the source of deep cervical infections, the importance of securing the airway, effecting surgical drainage and aggressive intravenous antibiotic therapy.

scholarly journals COMPARISON OF SHORT-TERM AND LONG-TERM COURSE OF ANTIBACTERIAL THERAPY FOR INTRA-ABDOMINAL INFECTION CAUSED BY ACUTE GANGRENOUS APPENDICITIS

2020 ◽  
Vol 20 (3) ◽  
pp. 159-163
Author(s):  
M.P. Shevchuk ◽  
M.O. Dudchenko ◽  
D.M. Ivashchenko ◽  
M.I. Kravtsiv
Keyword(s):  
Antibiotic Therapy ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Control Group ◽  
Adequate Treatment ◽  
Surgical Department ◽  
Abdominal Infection ◽  
Gangrenous Appendicitis ◽  
Infection Focus ◽  
Intra Abdominal Infection

Intra-abdominal infection and its complications is still remaining a fairly common and urgent global problem. Currently, there are a large number of publications providing guidelines and recommendations for the treatment of infections caused by a certain type of causative agents. However, the appropriate duration of antibiotic therapy is among the most controversial issues. Majority of clinicians tend to prescribe antibiotic therapy until all signs of inflammation disappear, usually for 7-14 days. But, in 1994, Schein M., and co-authors suggested that with adequate treatment of the focus of intra-abdominal infection, the duration of antibiotic therapy can be reduced to 3-4 days that in turn will reduce the resistance to antibacterial drugs. The aim of this study was to investigate the possibility in reducing antibiotic therapy length for patients with intra-abdominal infection caused by acute gangrenous appendicitis. The study included 32 patients aged 18 - 65 years, who were operated on for acute gangrenous appendicitis at the same day when admitted to the hospital at the surgical department of the 3rd Municipal Clinical Hospital of Poltava. The patients were divided into two groups. The first (study) group included 16 patients who received antibiotic therapy within minimum 3 days until the normalization of the leukocytosis and body temperature. The second (control) group included 16 patients who continued to receive antibiotic therapy for at least 2 days following the normalization of these criteria. Based on the results obtained in studying the effect of the length of antibiotic therapy course on intra-abdominal infection in the patients with acute gangrenous appendicitis during the postoperative period, we revealed the duration of antibiotic therapy for 3 ± 0.25 days showed similar results compared to the results of traditional and longer antibiotic therapy. The comparable values included periods of recovery and discharge following the surgery, the incidence of complications in the early and remote postoperative period. Our data confirm the concept that adequate surgical treatment of the infection focus in the abdominal cavity results in the reduction of antibiotic therapy length for several days after the operation without the risk of developing postoperative complications and recurrence of the infectious process.

scholarly journals Prevention and management of major complications in percutaneous endoscopic gastrostomy

2021 ◽  
Vol 8 (1) ◽  
pp. e000628
Author(s):  
Kurt Boeykens ◽  
Ivo Duysburgh
Keyword(s):  
Clinical Practice ◽  
Abdominal Wall ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Early Recognition ◽  
Endoscopic Technique ◽  
Abdominal Wound ◽  
Review Of The Literature ◽  
Endoscopic Gastrostomy ◽  
Major Complications ◽  
Life Threatening

BackgroundPercutaneousendoscopic gastrostomy is a commonly used endoscopic technique where a tube isplaced through the abdominal wall mainly to administer fluids, drugs and/orenteral nutrition. Several placement techniques are described in the literaturewith the ‘pull’ technique (Ponsky-Gardener) as the most popular one.Independent of the method used, placement includes a ‘blind’ perforation of thestomach through a small acute surgical abdominal wound. It is a generally safetechnique with only few major complications. Nevertheless these complicationscan be sometimes life-threatening or generate serious morbidity.MethodAnarrative review of the literature of major complications in percutaneousendoscopic gastrostomy.ResultsThis review was written from a clinical viewpoint focussing on prevention andmanagement of major complications and documentedscientific evidence with real cases from more than 20 years of clinical practice.ConclusionsMajorcomplications are rare but prevention, early recognition and popper management areimportant.

scholarly journals A case of amniotic fluid embolism successfully treated by multidisciplinary treatment

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Yuki Kinishi ◽  
Chiyo Ootaki ◽  
Takeshi Iritakenishi ◽  
Yuji Fujino
Keyword(s):  
Amniotic Fluid ◽  
Early Recognition ◽  
Multidisciplinary Treatment ◽  
Balloon Catheter ◽  
Amniotic Fluid Embolism ◽  
Pathological Examination ◽  
Total Blood ◽  
Occlusion Balloon ◽  
Life Threatening ◽  
Labor Epidural

Abstract Background Amniotic fluid embolism (AFE) is a life-threatening obstetric emergency. Because the maternal mortality associated with AFE is very high, early recognition and prompt treatment are important for improving the prognosis. We report a case of amniotic fluid embolism successfully treated by multidisciplinary treatment. Case presentation A 39-year-old woman with fetal congenital heart anomaly and polyhydramnios was scheduled for induction of delivery at 37 weeks of gestation with labor epidural analgesia. Uncontrollable bleeding occurred 30 min after vaginal delivery. Based on the clinical diagnosis of AFE, massive blood transfusion, insertion of an aortic occlusion balloon catheter, and hysterectomy was performed. Total blood loss was 12,000 mL. The diagnosis of AFE was confirmed by pathological examination. She was discharged with no complications. Conclusion We report a case of AFE who were rescued by prompt diagnosis and treatment.

scholarly journals Tick-Borne-Associated Illnesses in the Pediatric Intensive Care Unit

2020 ◽  
Vol 15 (06) ◽  
pp. 269-275
Author(s):  
Kaila Lessner ◽  
Conrad Krawiec
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Early Recognition ◽  
Spotted Fever ◽  
Pediatric Intensive Care ◽  
Rocky Mountain ◽  
Rocky Mountain Spotted Fever ◽  
Life Threatening ◽  
Human Ehrlichiosis

AbstractWhen unrecognized and antibiotic delay occurs, Lyme disease, Rocky Mountain–spotted fever, babesiosis, and human ehrlichiosis and anaplasmosis can result in multiorgan system dysfunction and potentially death. This review focuses on the early recognition, evaluation, and stabilization of the rare life-threatening sequelae seen in tick-borne illnesses that require admission in the pediatric intensive care unit.

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