An Uncommon Case of Splenic Abscess with Gangrenous Gas Necrosis

Splenic abscess is a rare clinical entity with diagnostic challenges. Though rare, it is potentially a life-threatening clinical condition with high mortality reaching more than 70%. The common signs and symptoms include the triad of fever, left upper quadrant tenderness, and leukocytosis. Early diagnosis, however, can readily be made by the combination of clinical features, abdominal ultrasonography (USG), and computed tomography (CT). The management of splenic abscess includes medical therapy, CT-guided percutaneous aspiration, and splenectomy. We, hereby, present a rare case of splenic abscess with gangrenous gas necrosis, who underwent splenectomy.

Percutaneous Aspiration Thrombectomy for Arterial Thromboembolic Occlusion Following Percutaneous Transluminal Angioplasty: Technical Success Rates and Clinical Outcomes

Purpose We aimed to analyze the technical success rate of manual percutaneous aspiration thrombectomy (PAT) in patients with peripheral arterial thromboembolism as a complication of infrainguinal percutaneous transluminal angioplasty (PTA) and we sought to evaluate the 30-day postintervention clinical outcome. Materials and Methods We retrospectively identified 29 patients (men/women, 18/11; mean age, 74 years) who underwent infrainguinal PAT to treat thromboembolic complications of infrainguinal PTA. Primary and secondary technical successes were defined as residual stenosis of < 50 % of the vessel diameter after PAT alone and PAT with additional PTA, respectively. Clinical outcome parameters (e. g., amputation, need for further intervention) were evaluated during the first 30 days after intervention. Results The primary and secondary technical success rates were 58.6 % (17/29) and 79.3 % (23/29), respectively. Clinical outcome data were available for 93.1 % (27/29) of patients. No further intervention was required within 30 days in 81.5 % (22/27) of patients. Four patients underwent minor amputations owing to preexisting ulcerations (Rutherford Category 5), and no patients underwent major amputations (Rutherford Category 6). Revascularization of the previously treated vessel segment with PTA was necessary on the first postintervention day in one patient. Conclusion Manual PAT, with PTA if needed, has a good technical success rate and satisfactory early clinical outcome in patients with iatrogenic thromboembolic complications after infrainguinal PTA. Key Points: Citation Format

Compare the Outcome of Percutaneous Aspiration with Incision Drainage for Management of Breast Abscess

Objective: The aim of this study is to compare the outcome of percutaneous aspiration with incision drainage for management of breast abscess. Study Design: Comparative Study Place and Duration: The study was conducted at Surgery departments of Lady Reading hospital, Peshawar during the period of six months from August 2020 to January 2021. Methods: Total 110 women were presented in this study. Patients were aged between 20-45 years. Patients’ detailed demographics including age, weight, height and body mass index were recorded after taking informed written consent. Women had breast abscess were included. Patients were equally divided into two groups, I and II. Group I had 55 patients and received percutaneous aspiration while in group II 55 patients were underwent for incision drainage. Outcomes among both groups were compared in terms of early restoration of breast feeding, pain score by using VAS and time of healing. Complete data was analyzed by SPSS 24.0 version. Results: Mean age of the patients in group I was 30.11±8.56 years with mean BMI 26.9±3.77 kg/m2 while mean age in group II was 29.17±9.44 years with mean BMI 26.08±3.27 kg/m2. Mean weight of patients in group I was 72.19±17.44 kg and in group II mean weight was 74.35±19.78 kg. Mean height in group I was 154.12±9.55 cm and in group II was 156.08±8.71 cm. Restoration of breast feeding among group I was 47 (85.45%) and in group II 32 (58.2%) patients restored breast feeding. Satisfaction among patients in group I was higher than that of 45 (81.82%) as compared to group II 31 (56.4%). Conclusion: We concluded in this study that percutaneous aspiration in breast abscess was successful and affective as compared to incision drainage with less complications and high satisfaction rate among the women. Keywords: Breast abscess, Percutaneous aspiration, Incision drainage,

Compare the Outcome of Percutaneous Aspiration with Incisional Drainage for Management of Breast Abscess

Objective: To compare the outcome of percutaneous aspiration with incision drainage for management of breast abscess. Study Design: Comparative study Place and Duration of Study: Department of Surgery Unit-1, Sandeman Provincial Hospital Quetta from 1st October 2020 to 31st March 2021. Methodology: One hundred and ten women age aged between 18-65 years of age were enrolled. Patients details demographics age, weight, height and body mass index were recorded after taking informed written consent. Women had breast abscess were included. Patients were equally divided into two groups, I and II. Group I had 55 patients and received percutaneous aspiration while in group II had 55 patients underwent for incision drainage. Results: Mean age of the patients in group I was 30.11±8.56 years with mean BMI 27.9±18.77kg/m2 while mean age in group II was29.17±9.44 years with mean BMI 28.9±55.27kg/m2. Mean weight of patients in group I was 72.19±17.44 kg and in group II mean weight was 74.35+19.78 kg. Mean height in group I was 154.12±9.55 cm and in group II was 156.08+8.71 cm. Restoration of breast feeding among group I was 47 (85.45%) and in group II 32 (58.2%) patients restored breast feeding. Satisfaction among patients in group I was higher than that of 45 (81.82%) as compared to group II, 31 (56.4%). Conclusion: Percutaneous aspiration in breast abscess was successful and affective as compared to incision drainage with less complications and high satisfaction rate among the women. Keywords: Breast abscess, percutaneous aspiration, Incision drainage

Comparative Study between Open Surgical Drainage and Closed Technique of Percutaneous Aspiration under Image Guidance for Management of Breast Abscess

Background: The conventional surgical management of breast abscesses consists of an incision taken over the point at which there is maximum fluctuation (or pain) and breaking of the abscess septa by digits. Now antibiotics and repeated abscess aspiration under USG guidance is new minimally invasive method which is on rise Objectives: To study the outcome of open technique of breast abscess management. To study the outcome of closed technique of breast abscess management. To compare the outcome of open v/s closed technique of surgical management of breast abscess. Methodology: Sample will be divided into two groups and type of treatment i.e open incision and drainage or percutaneous aspiration under guidance will be decided randomly by chit system. Expected Results: Feasibility and outcome of Percutaneous drainage is better than incision and drainage Conclusion: First line management of Breast abscess will soon be percutaneous drainage under USG guidance.

Treatment of a giant hepatic echinococcal cyst with percutaneous drainage and in vivo assessment of the protoscolicidal effect of praziquantel

Therapy choices for cystic echinococcisis (CE) are stage-specific: surgical, minimally invasive, medical or observation without intervention. PAIR (percutaneous aspiration, instillation of a scolicide, and re-aspiration) has been considered the treatment of choice for uncomplicated echinococcal liver cysts. However, PAIR carries the risk of toxic cholangitis or hypernatremia and that the cyst frequently refills with bile after withdrawing the catheter. We treated a patient with a giant CE 1 liver cyst with puncture drainage (PD) under albendazole coverage. Drainage enabled us to monitor the morphology of protoscolices under praziquantel (PZQ) co-medication. Protoscolices degenerated within 5 days of PZQ 50 mg/kg/d. The cyst cavity solidified with no evidence of reactivation or secondary spread. Percutaneous treatments can replace surgery in a significant number or cases with hepatic CE. PD allows to assess microscopically the viability of protoscolices under co-medication with PZQ–albendazole and to avoid the instillation of topical scolicides.