scholarly journals Enterocutaneous Fistula and Abscess Diagnosed with Point-of-care Ultrasound

2021 ◽  
Vol 5 (4) ◽  
pp. 470-472
Author(s):  
Sarah McCuskee ◽  
Kenton Anderson
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Point Of Care ◽  
Enterocutaneous Fistula ◽  
Fluid Collection ◽  
Source Control ◽  
Point Of Care Ultrasound ◽  
Mesh Infection ◽  
Umbilical Hernia Repair ◽  
Infected Mesh

Case Presentation: A 64-year-old female with history of umbilical hernia repair with mesh 18 years prior, cystocele, and diabetes mellitus presented with 10 days of abdominal and flank pain. The patient was tachycardic, normotensive, afebrile, and had an erythematous, tender, protuberant abdominal wall mass. Point-of-care ultrasound (POCUS) revealed an irregular, heterogeneous extraperitoneal fluid collection with intraperitoneal communication; these findings were consistent with an abscess and infected mesh with evidence for intraperitoneal extension. The diagnosis of enterocutaneous fistula (ECF) with infected mesh and abdominal wall abscess was confirmed with computed tomography and the patient was admitted for antibiotics and source control. Discussion: A rare complication of hernia repair with mesh, ECF typically occurs later than more common complications including cellulitis, hernia recurrence, and bowel obstruction. In the emergency department, POCUS is commonly used to evaluate for abscess; in other settings, comprehensive ultrasound is used to evaluate for complications after hernia repair with mesh. However, to date there is no literature reporting POCUS diagnosis of ECF or mesh infection. This case suggests that distant surgery should not preclude consideration of mesh infection and ECF, and that POCUS may be useful in evaluating for these complications.

scholarly journals Management of non-absorbable mesh infection after hernia repair by negative pressure wound therapy

2019 ◽  
Vol 13 (1) ◽  
pp. 008
Author(s):  
Amreen Faruq ◽  
HM Sabbir Raihan ◽  
Muhtarima Haque
Keyword(s):  
Hernia Repair ◽  
Granulation Tissue ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Mesh Infection ◽  
Wound Therapy ◽  
Absorbable Mesh ◽  
Deep Wound ◽  
Infected Mesh ◽  
A Prospective Study

Background and objectives: Mesh infection following hernia repair has previously often resulted in removal of mesh. The aim of this study was to evaluate if negative pressure wound therapy (NPWT) can be used to treat such complications and preserve the mesh. Materials and method: A prospective study was carried in the Department of Surgery, BIRDEM General Hospital from January 2017 to January 2019. Patients with deep wound infection and exposed infected mesh after hernioplasty were included in the study. Patients’ demographics, existing comorbidities and outcome were recorded. All patients were treated with NPWT till the wound was covered with healthy granulation tissue and closed. Results: NPWT was used to treat 7 patients with mesh infection following hernia repair. There was 2 male and 5 female cases and age ranged from 38-58 years. With NPWT the mesh in 6 patients (86%) out of 7 could be completely salvaged and wound closed with secondary suturing. However, in 1 patient although the mesh covered with granulation tissue by NPWT and wound was closed; but it had to be partly removed later on due to development of chronic discharging sinus 20 days after stitch removal. Conclusion: The study demonstrated that NPWT was a useful technique for the treatment and preservation of infected mesh after hernia repair. IMC J Med Sci 2019; 13(1): 008

scholarly journals Simple Pneumonia or Something More?: A Case Report and Discussion of Unexpected Empyema Identified by Point-of-Care Ultrasound

CJEM ◽  
2015 ◽  
Vol 18 (5) ◽  
pp. 391-394
Author(s):  
Michael Romano ◽  
Tomislav Jelic ◽  
Jordan Chenkin
Keyword(s):  
Emergency Department ◽  
Point Of Care ◽  
Fluid Collection ◽  
Chest Ct ◽  
Point Of Care Ultrasound ◽  
X Ray ◽  
Level Of Consciousness ◽  
Chest X Ray ◽  
Ultrasound Assessment ◽  
Higher Sensitivity

AbstractThere is evidence to suggest that point-of-care ultrasound assessment of the lungs has a higher sensitivity and specificity than chest radiography for the diagnosis of pneumonia. It is unknown if the same is true for pneumonia complications. We present and discuss the case of a 61-year-old woman who presented to the emergency department with confusion, decreased level of consciousness, and signs of sepsis. A chest x-ray revealed a right sided infiltrate. An ultrasound of the patient’s lungs was performed, and revealed a complex loculated fluid collection consistent with an empyema. A chest CT confirmed the diagnosis, and immediate percutaneous drainage was performed.

scholarly journals Delayed laparoscopic mesh infection presenting as an abdominal mass

2015 ◽  
Vol 97 (6) ◽  
pp. e88-e89 ◽  
Author(s):  
JML Williamson ◽  
P Newman ◽  
CP Armstrong
Keyword(s):  
Hernia Repair ◽  
Abdominal Mass ◽  
Mesh Infection ◽  
Rare Occurrence ◽  
Initial Operation ◽  
Bilateral Hernia ◽  
Totally Extraperitoneal ◽  
Femoral Vessels ◽  
Infected Mesh ◽  
The Right

A 56-year-old man presented with a delayed mesh infection 8 years following an elective laparoscopic totally extraperitoneal (TEP) bilateral hernia repair. Sterile pus was drained percutaneously as a temporising measure prior to removal of the right-hand mesh; the left-sided mesh was adherent to the femoral vessels and minimally contaminated. Delayed mesh infection is a rare occurrence. This case is the fourth example and the longest following initial operation. Removal of the infected mesh is advocated.

scholarly journals POCUS Evaluation in Acute Kidney Injury

POCUS Journal ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 67-69
Author(s):  
Vanessa Hoytfox ◽  
Brittney Ward ◽  
Emily Cox ◽  
Kang Zhang
Keyword(s):  
Acute Kidney Injury ◽  
Point Of Care ◽  
Fluid Collection ◽  
Complicated Urinary Tract Infection ◽  
Kidney Injury ◽  
Clinical History ◽  
Clinical Problem ◽  
Point Of Care Ultrasound ◽  
Renal Sinus ◽  
General Internal

Acute kidney injury is a common clinical problem encountered in general internal medicine. The evaluation of acute kidney injury is mainly driven by the patient’s clinical history, physical exam and basic urinary/laboratory investigation. Point of care ultrasound (POCUS) may be a useful tool to help clinicians to narrow and/or prioritize differential diagnosis in patients presenting with acute kidney injury. Here we present a case of a 67-year old male presenting with dysuria, fevers, and flank pain along with elevation in serum creatinine who was admitted for acute kidney injury secondary to complicated urinary tract infection. Subsequent renal POCUS showed bilateral anechoic fluid collection within the renal sinus with dilated calyces suggestive of bilateral hydronephrosis most likely due to a new diagnosis of benign prostatic hyperplasia. This case demonstrates the use of POCUS added valuable diagnostic information and therapeutic management for this patient presenting with acute kidney injury.

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