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28
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Schwartz ID, Olson LC. Left pleural effusion: masking subphrenic abscess--caused by Salmonella enteritidis serotype Heidelberg. Clin Pediatr (Phila) 1989; 28:266-7. [PMID: 2656053 DOI: 10.1177/000992288902800606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The authors describe a young girl presenting with fever and respiratory distress and a chest x-ray showing a left lower lobe infiltrate and an effusion. She also had splenomegaly. Salmonella enteritidis serotype Heidelberg was isolated by thoracentesis. Further evaluation disclosed an occult but large left subphrenic abscess, explaining the misleading presentation and radiograph. A review of salmonella infections associated with subphrenic abscess is discussed.
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29
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Lokhvitskiĭ SV, Suleĭmenova RN, Borisov AI. [Transdiaphragmatic bronchopleural fistulas as complications of subdiaphragmatic abscesses]. GRUDNAIA KHIRURGIIA (MOSCOW, RUSSIA) 1989:71-7. [PMID: 2744614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The authors had 21 patients with various types of transdiaphragmatic bronchopleural fistulas which development as secondary complications of a subdiaphragmatic abscess as a consequence of late diagnosis, ineffective drainage, and use of transpleural approaches to the abscesses. Clinical and radiological diagnosis including contrast fistulo- and pleurography, bronchography and bronchoscopy, and contrast endoscopic examination of the stomach and other organs made it possible to determine the character and localization of the transdiaphragmatic fistula and the condition of the sprained organs. The therapeutic tactics were determined by the form and causes of the transdiaphragmatic bronchopleural fistulas. Nineteen patients recovered, 2 died. The success of treatment depended on the time when operative drainage was begun and on its rational application on bronchological cleansing, and on other components of complex treatment.
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30
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Trimble GX. Nonsuppurative pericardial effusion. West J Med 1989; 150:347-8. [PMID: 2735040 PMCID: PMC1026473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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31
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Buromskaia GA, Shapoval'iants SG, Mikhaĭlusov SV, Kudakov GS, Nemnonov AA. [Surgical treatment of multiple abscesses of the liver]. Khirurgiia (Mosk) 1988:140-1. [PMID: 3066974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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32
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Horton JM, Tucker WS. Pericarditis with effusion and tamponade complicating left subdiaphragmatic abscesses. West J Med 1988; 149:213-5. [PMID: 3247738 PMCID: PMC1026387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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33
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Neff CC. Splenobronchial fistula: interventional radiologic management. GASTROINTESTINAL RADIOLOGY 1987; 12:197-9. [PMID: 3596135 DOI: 10.1007/bf01885140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A 71-year-old man had a splenic abscess complicated by rupture into the left subphrenic space with formation of a splenobronchial fistula. One percutaneous catheter was placed into the splenic abscess and a second was placed in the subphrenic collection. The abscesses resolved and the bronchial fistula closed in 12 days.
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Abstract
A patient with subphrenic abscess can present with pulmonary or abdominal symptoms because of the location of the abscess adjacent to the diaphragm. This thoracoabdominal clinical complex has been described previously and, if chest symptoms predominate, may obscure the diagnosis of subphrenic abscess. The case of a patient with occult abdominal pathology who presented with respiratory complaints is discussed.
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35
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Nikhinson RA, Lubenskiĭ IM. [Extended, combined and associated resection of the liver]. VESTNIK KHIRURGII IMENI I. I. GREKOVA 1987; 139:52-5. [PMID: 3441970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The authors describe their observations of 227 patients after operations for focal lesions of the liver. Radical operations were performed on 93 patients, 61 being subjected to extended, combined and associated resections of the liver. Most operations were made as atypical resections of the liver. In order to reduce the operation blood loss the authors recommend to fulfil temporary exclusion of the liver from blood circulation by compression of the hepato-duodenal ligament. The temporary external drainage of bile ducts is recommended as a preventive measure against post-operative bile peritonitis. Postoperative lethality after extended, combined and associated resections of the liver was 9.8%.
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36
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Formato A, Ottaviano A, Quarto G, Mozzillo N. [Chlorhexidine gluconate in the treatment of subphrenic abscess and thoracic empyema]. MINERVA CHIR 1987; 42:1271-3. [PMID: 3670664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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37
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Manenti A, Curti L, Botticelli A, Speranza M. [Acute peritonitis caused by a ruptured splenic abscess]. JOURNAL DE CHIRURGIE 1987; 124:489. [PMID: 3693452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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38
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Cohen AJ, Bridges R, Rowen SJ. Communicating gastric-subphrenic abscess proven by combined technetium-99m pertechnetate and sulfur colloid imaging. Clin Nucl Med 1987; 12:403-4. [PMID: 3034467 DOI: 10.1097/00003072-198705000-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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39
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Abstract
Congenital cystic dilatation of the biliary tree (Caroli's disease) is a rare condition that usually presents with ascending cholangitis. This report demonstrates the difficulty of recognizing other complications of Caroli's disease antemortem. A 35-year-old man developed a subphrenic abscess and malignant transformation of the biliary tree; both were clinically undetected. Episodes of pain, pyrexia, or weight loss should be assessed carefully and the complications of Caroli's disease considered before attributing such symptoms to recurrent cholangitis.
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Guarnieri A, Breggia M, De Sando D, D'Aniello C, Piccolomini A, Trombì G, Bruttini S, Savelli V, De Stefano A. [Postoperative subphrenic abscesses. A clinical contribution]. MINERVA CHIR 1986; 41:1039-43. [PMID: 3736934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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41
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Peterson CM, Theander C. [Tooth infection spreading to the abdominal cavity]. LAKARTIDNINGEN 1986; 83:412-3. [PMID: 3951277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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42
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Abstract
A case of left-sided subphrenic abscess, secondary to perforation of a carcinoma of stomach, is described. The patient presented with a palpable spleen which was shown to be normal in size but displaced by the subphrenic collection. The importance of correct interpretation of this physical sign is discussed.
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43
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Light RW. Exudative pleural effusions secondary to gastrointestinal diseases. Clin Chest Med 1985; 6:103-11. [PMID: 3847297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Several different diseases of the gastrointestinal tract may have an associated exudative pleural effusion. In the acutely ill patient with a pleural effusion, the possibility of esophageal perforation should always be considered. It is important to establish this diagnosis as soon as possible since the mortality rate increases markedly if drainage of the mediastinum is delayed for even 12 or 24 hours. The best screening test for esophageal rupture is the level of amylase in the pleural fluid. All patients with undiagnosed exudative pleural effusions should have the amylase level in their pleural fluid measured to rule out a pancreatic etiology for their pleural effusion. In patients with acute pancreatitis, the clinical presentation may be dominated by chest symptoms. Such patients have small to moderately sized pleural effusions that resolve rapidly once appropriate therapy is instituted. If symptoms persist, the possibility of a pancreatic abscess or a pancreatic pseudocyst should be considered. Patients with pancreatic pseudocysts may develop a sinus tract between the pseudocyst and the pleural space. In this situation a large pleural effusion develops. Frequently there are no abdominal symptoms and the diagnosis will not be made unless a pleural fluid amylase is obtained. Patients with exudative pleural effusions that contain predominantly polymorphonuclear leukocytes should be suspected of having an intra-abdominal abscess, particularly when there is no associated parenchymal infiltrate. Subphrenic, intrahepatic, and splenic abscesses all have a high incidence of accompanying pleural effusion. Abdominal CT scanning is the method of choice to establish each of these diagnoses.
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LaManna MM, Candy A, Boland CN, Pickering NJ, Barnes AU, Parker JA. Hepatobiliary-lung imaging. A case report. Clin Nucl Med 1985; 10:90-2. [PMID: 4039240 DOI: 10.1097/00003072-198502000-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The use of combined hepatobiliary-lung imaging in the diagnosis and evaluation of a subphrenic process is described.
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Abstract
Over the past 9 years, ten patients have presented to the Thoracic Unit, Glasgow Royal Infirmary, with 12 empyemas secondary to intra-abdominal sepsis. In eight patients, the presenting signs and symptoms were wrongly attributed to primary intra-thoracic pathology. All were subsequently found to have intra-abdominal sepsis. The presence of empyema after recent abdominal surgery or abdominal pain strongly suggests a diagnosis of ipsilateral subphrenic abscess. Adequate surgical drainage is essential. In our experience, limited thoracotomy with subdiaphragmatic extension offers the best access to both pleural and subphrenic spaces and provides the greatest chance of eradicating infection on both sides of the diaphragm.
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Kasanuki J, Ishikawa T, Imaizumi T, Koseki H, Kaneko R, Shimada N, Ozawa Y, Tokumasa Y, Yoshida S, Tosa H. [A suspicious case of Crohn's disease of the ileum complicated with subphrenic abscess]. NIHON SHOKAKIBYO GAKKAI ZASSHI = THE JAPANESE JOURNAL OF GASTRO-ENTEROLOGY 1984; 81:1837-41. [PMID: 6392624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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47
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Kalimanovska D, Colović R. [Purulent pericarditis in a patient with an abscess in the left lobe of the liver in the subphrenic area]. SRP ARK CELOK LEK 1984; 112:717-23. [PMID: 6395363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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48
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Heydenrych JJ, Warren B. An unusual presentation of carcinoma of the colon in a child. A case report. S Afr Med J 1984; 65:617-8. [PMID: 6710273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
A patient with carcinoma of the large bowel who presented with a subphrenic abscess is reported. This case emphasizes two important facts relating to colonic cancer in childhood: (i) premalignant disease of the large bowel is no prerequisite for the development of colonic cancer; and (ii) in childhood this disease is characterized by a fulminating course and high mortality. In about 50% of cases the tumour is of the signet ring or mucin-producing type, which explains the grave prognosis.
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Stanley P, Atkinson JB, Reid BS, Gilsanz V. Percutaneous drainage of abdominal fluid collections in children. AJR Am J Roentgenol 1984; 142:813-6. [PMID: 6608246 DOI: 10.2214/ajr.142.4.813] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Percutaneous drainage of intraabdominal fluid collections was performed in 13 children. After initial diagnosis with either sonography or computed tomography, a smallbore aspiration needle (22 gauge) was guided into the collection, usually by sonography. In five patients, complete evacuation was possible using the aspirating needle alone. In seven others, the fluid was successfully drained via a catheter introduced percutaneously. In one patient, surgery was required for complete evacuation of a hematoma containing large blood clots. There were no complications.
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50
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Greenstein AJ, Lowenthal D, Hammer GS, Schaffner F, Aufses AH. Continuing changing patterns of disease in pyogenic liver abscess: a study of 38 patients. Am J Gastroenterol 1984; 79:217-26. [PMID: 6702806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Changes in the etiology, clinical features, methods of diagnosis, and treatment of pyogenic liver abscess have occurred slowly but continuously over the past century. The earlier changes are well documented in the literature, and continuing variations in the classic patterns of disease are now evident. These include 1) a recent increase in incidence reflecting more accurate diagnostic techniques; 2) changes in bacteriology with a high incidence of Klebsiella infection; 3) a reduction in mortality, reflecting earlier diagnosis and more refined therapeutic methods; and 4) changes in the population at risk namely a large population of terminal cancer patients. Thirty-eight patients treated at the Mount Sinai Hospital over the past 16 years, 1967-1982, have been divided into two groups, each of 8 years duration, reflecting an earlier era before routine use of scanning procedures, and a later period when technetium, gallium, sonographic, and more recently CT imaging procedures were regularly done. During the latter period there was a significant increase in both the total number of liver abscesses diagnosed and in the number estimated as a proportion of all hospital admissions. Mortality has continued to fall to more acceptable levels with a 25% reduction overall. In the early era, extrahepatic intra-abdominal infection caused all four deaths. In the past 8 years obstructing or metastatic cancer has caused four of the five deaths. Bacteremia occurred in six of the nine deaths, five of these being of biliary origin. The decrease in mortality may reflect earlier diagnosis, an increase in the number of solitary abscesses, and better therapy.
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