• Title/Summary/Keyword: liver abscess

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Utility of a modified components separation for abdominal wall reconstruction in the liver and kidney transplant population

  • Black, Cara K;Zolper, Elizabeth G;Walters, Elliot T;Wang, Jessica;Martinez, Jesus;Tran, Andrew;Naz, Iram;Kotha, Vikas;Kim, Paul J;Sher, Sarah R;Evans, Karen K
    • Archives of Plastic Surgery
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    • v.46 no.5
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    • pp.462-469
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    • 2019
  • Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was $61.0{\pm}8.3years\;old$, with a mean body mass index of $28.4{\pm}4.8kg/m^2$, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of $28.7{\pm}22.8months$. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.

Hereditary Hemorrhagic Telangiectasia (유전성출혈모세혈관확장증의 증례 및 문헌 고찰)

  • Kwon, Jeong-Seung;Ahn, Hyung-Joon;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.37 no.3
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    • pp.135-139
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    • 2012
  • Hereditary hemorrhagic telangiectasia is a rare autosomal dorminant disease that features abnormal and fragile vascular dilations of terminal vessels in skin and mucous membranes, as well as arteriovenous malformations of internal organs, particularly lungs, brain, and liver. Often patients have not been diagnosed with HHT for a long time, and undiagnosed HHT patients unnecessarily develop serious complications such as severe life-threatening hemorrhage, stroke or brain abscess. Therefore, early detection and appropriate screening is very important. Early detection of HHT allows the appropriate screening for the presence of silent disease such as AVMs in the lungs, liver, or brain, and preventive treatment in the patient and their affected family members. Dentists should be familiar with HHT because the telangiectases on skin and oral mucosa are often the most dramatic and most easily identified component of HHT. Recently, we experienced a case of HHT. We present the case with a review of the literature.

A Literature Study on the Cervical Lymphic Node (나역에 대한 文獻的 考察(處方과 藥物을 중심으로))

  • Min, Young-gye;Jeong, Dong-hwan;Sim, Sang-Hui;Park, Su-yeon;Kim, Jong-han;Choi, Jung-hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.16 no.2
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    • pp.1-45
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    • 2003
  • We get the conclusion this following through bibliographic consideration about the cause of disease, disease mechanisms and remedy, prescription of tuberculosis of the cervical lymphic node. 1. The tuberculosis of the cervical Iymphic node is named the linear lump of scrofula(마도라력), the scrofula around neck(반사력), the wide-spread scrofula(류주력), the papule like lotus seed(련자력), the scrofula(라력), the subcutaneous nodes(結核), the scrofula due to disorder of Gi(기력) and the scrofula due to accumulation of phlegm(담력) according to the criterion of regions of disease, causes, rounding parts and shapes. 2. The cause of the tuberculosis of the cervical lymphic node are the stagnation of liver Gi(肝氣鬱結), the accumulation of phlegm and the stagnation of Gi(痰凝氣滯), the deficiency of vital essence of the liver and kidney(肝腎陰虛), the wind-heat of liver, gallbladder and triple warmer(肝膽三焦風熱), the dry-fire(燥火), the dryness of blood(血燥), the unwholesome diet(飮食不潔), the abundance of diet(食味之厚), the stagnation of Gi(鬱氣之積), the exhaustion syndrome(虛勞), the excessive thought(思慮過多), the toxin of wind-heat(風熱毒) and the germ of subcutaneous nodes(結核菌). 3. Symptoms of the tuberculosis of the cervical lymphic node are swelling slowly in comparison in the early days of occurrence, and are not pain, not itch, not heat, not other special symptoms. But in some cases, tuberculosis of the cervical lymphic node are quickly swelling in the early days of occurrence, and the fever and pain appear, The pyosis is accompanied with the fever and the pain at first generally, and then removing the pus from abscess is dissolved the fever and the pain in the majority of cases and representative of the general exhaustion syndrome. 4, The remedy of tuberculosis of the cervical Iymphic node is the early days, clearing the liver and relieves constraint(疏肝解鬱), phlegm and dissolving accumulation(化痰散結) the middle days, pus draining and toxin expelIing(托裏透膿) the latter days, replenish the kidney and strengthen the spleen(滋腎健脾). 5. The medication to treat the tuberculosis of the cervical lymphic node are the 益氣養榮湯(lkgiyangyoungtang)(14th), the 夏枯草散(Hagochosan)(10th) and et cetra in regular sequence. 6. The herb to treat the tuberculosis of the cervical Iymphic node are the 連翹(FRUCTUS FORSYTHlAE)(59th), the 甘草(RADIX GLYCYRRHIZAE)(51th), the 當歸(RADIX ANGELICAE GlGANTIS)(47th), the 黃芩(RADlXSCUTELLARIAE)(40th), the 夏枯草(SPICA PRUNELLAE)(23th) in regular sequence.

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Clinical Experience of Acute Pericarditis with Effusion (삼출액을 동반한 급성심낭염의 임상적 고찰)

  • Park, K.;Yoo, J.S.;Kim, Y.H.;Jo, K.D.;Park, J.K.;Wang, Y.P.;Kim, S.W.;Lee, H.K
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.190-196
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    • 1991
  • Clinical experience of 48 acute pericarditis with effusion was reviewed and presented. There were 28 male and 20 female patients ranging from 3 years to 77 years old. Malignant effusion; Twenty patients had underlying malignancy. These etiologies were lung ca[8 patients, 40%], breast ca[7 patients 35%], lymphoma[2 patients, 10%], esophageal ca[1 patients, 5%], stomach ca[1 patient, 5%], ovarian ca[1 patient, 5%]. Uremic effusion; 15 patients with renal failure required surgical intervention. Traumatic effusion; 7 patients had traumatic pericarditis. These etiologies were stab wound [5 patients, 71.4%] and aspiration[2 patients, 28.6%]. Pyogenic effusion: 6 patients had pyogenic pericarditis. These etiologies were empyema thoracis[3 patients, 50%], liver abscess[2 patients, 33.3%], pneumonia[1 patient, 16.7%]. The patients were treated by pericardiocentesis, subxiphoid tube drainage, pericardiectomy: 4 of them underwent pericardiocentesis; 37, subxiphoid tube drainage; 5, pericardiectomy. We conclude that subxiphoid tube pericardial drainage was effective for treatment of pericardial effusion.

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A case of meningoencephalitis caused by $Listeria$ $monocytogenes$ in a healthy child

  • Lee, Ji-Eun;Cho, Won-Kyoung;Nam, Chan-Hee;Jung, Min-Ho;Kang, Jin-Han;Suh, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • v.53 no.5
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    • pp.653-656
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    • 2010
  • $Listeria$ $monocytogenes$ is a facultative anaerobic, gram-positive bacillus that is isolated from the soil, vegetables, and wild or domestic animals. Listeria occurs predominantly in the elderly, immunocompromised patients, pregnant women and newborns. Infections by this microorganism are rare in healthy infants and children. $L.$ $monocytogenes$ may cause meningitis, meningoencephalitis, brain abscess, pyogenic arthritis, osteomyelitis, and liver abscesses in children. The course of meningoencephalitis by listeria is often severe and even fatal. Acute hydrocephalus can develop as a complication and the mortality associated with listeriosis is significantly high. We present a case of meningoencephalitis caused by $L.$ $monocytogenes$ in a previously healthy 7-year-old girl.

Nonoperative Management of Children with Blunt Abdominal Trauma (복부 둔상을 입은 소아에서의 비수술적 치료)

  • Kim, Kyung-Jae;Lee, Doo-Sun
    • Advances in pediatric surgery
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    • v.2 no.2
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    • pp.94-99
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    • 1996
  • The management of twenty-two children with blunt abdominal trauma was analyzed. Nineteen cases had intraabdominal injuries; involving the spleen in 7 cases, the liver in 5, the pancreas in one and the bladder in one. There were five case multiple intraabdominal organ injuries. Seventeen out of 19 patients were treated non-operatively, but one was operated upon later because of delayed bleeding. Thirteen patients required transfusion in the non operated group, the mean values of the Pediatric Trauma Score (PTS) was 11.3. The mean lowest hemoglobulin(LHb) was 9.1 g/dL. The mean value of three cases with extraabdominal injuries were 9.0 and 8.3 g/dL respectively. The average amount of transfusion was 17.3 ml/kg. In the operated group, 2 cases were transfused an average of 139.8 ml/kg and their mean PTS was 5 and LHb was 6.6 g/dL. In one out of 16 non-operated cases, intrahepatic hematoma developed and but resolved conservatively. However, two out of 3 operated cases suffer complications such as an intubation granuloma and an intraabdominal abscess with wound dehescence. In conclusion, non-operative management in child with blunt abdominal trauma was safe in Grade I and II solid organ injuries. The decision for operation should be based on the hemodynamic stability after initial resuscitation including transfusion.

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Two Case of Pulmonary Arteriovenous Fistula Treatment Depending on the Presence of Pulmonary Hypertension (폐동맥고혈압 동반여부에 따른 폐동정맥루의 치료)

  • Huh, Yun Jeong;Kim, Jeong Tae;Choi, Jae Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.216-220
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    • 2005
  • Pulmonary arteriovenous fistulas(PAVFs) is a rare disorder that occurs in two to three children per 100,000 population. It is presented as absence of intervening capillary beds between the pulmonary artery and vein with resultant persistent right to left shunt. Other causes include trauma, liver cirrhosis, malignancy and schistosomiasis. It is mostly asymptomatic, but it may present with respiratory difficulty, cyanosis, clubbed fingers induced by right to left shunt or hemoptysis, polycythemia and epistaxis. Major complications, such as brain abscess, brain embolism, paradoxical embolism and subacute infective endocarditis can be devastating, so therapeutic intervention is recommended in all patients. However, removal of low-resistance fistulas can aggrevate pulmonary hypertension, so detection of increased pulmonary pressure is important. We report two patients : One a 42 year-old male with PAVFs treated with coil embolization, and a 42 year-old female who was treated with anticoagulants due to pulmonary hypertension.

Clinical Evaluation of $^{57}Co-labelled$ Bleomycin for Tumor Localization ($^{57}Co-BLM$을 이용한 종양진단 신티그라피에 관한 연구)

  • Ryu, Young-Wun;Kim, Jang-Hee;Lee, Jhin-Oh
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.1
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    • pp.61-68
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    • 1987
  • Investigation with $^{57}Co-Bleomycin$ in patients with the various cancers and in tumor bearing animals are descirbed. In the patients, $^{57}Co-Bleomycin$ appears to be one of the useful tumor-seeking radiopharmaceuticals, and worth applicable to clinical uses. Labelled yield of $^{57}Co-Bleo$ was about 97 % by thin layer chromatography. The pyrogen free tests were performed to meet U.S.P. critical ranges. In clinical studies with $^{57}Co-Bleo$, 4 cases out of 5 patients with lung cancer., 2 cases among 3 thyroid cancer patients, and all 3 hepatoma patients showed positive tumor scans. The patients with stomach cancer, and the esophageal cancer showed false negative scintigraphy. A case with pulmonary tuberculosis showed a positive scan while liver abscess showed a negative picture. The merits of $^{57}Co-Bleomycin$ scintigraphy seems to be its relatively high affinity to tumors and low radiation hazard in spite of long physical half life.

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Pericarditis Arisen from Liver Abscess: Report of 2 Cases (간농양에 병발한 심낭염 치험 2례)

  • 서충헌
    • Journal of Chest Surgery
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    • v.14 no.2
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    • pp.140-143
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    • 1981
  • Thymolipoma is extremely uncommon benign mediastinal tumor consisting of fatty and thymic tissue. Only 50 verified cases have been reported in the world literatures. This one case is the first reported example of surgically treated thymolipoma associated with spontaneous pneumothorax. A thirty-two year old male patient had been in good health until two days prior to admission, when he noted sudden dyspnea associated with an aching pain over the left precordium. The dyspnea and chest pain had become progressively worse. The physical examination revealed that left hemithorax was tympanic sound on percussion and absence of breathing sound on auscultation and point of maximal impulse was located on the 4th intercostal space at the left sternal border. Emergency closed thoracostomy was performed under the impression of tension type spontaneous pneumothorax of the left lung. After closed thoracostomy, point of maximal impulse was not changed inspire of full expansion of the left lung and chest X-ray was strongly suggested pericardial effusion or cardiomegaly which couldn`t account for by clinical course and hemodynamic evidence. EKG, echocardiogram, bronchofiberoscophy, bronchogram and diagnostic thoracentesis was performed. On Dec. 8, 1980, operation was performed under the impression of mediastinal tumor in the anterior mediastinum. At left posterolateral thoractomy, a large fatty mass, measuring 35 x 27 x 13 Cm in dimension and weighing 3350 gm, was resected and multiple bullae on the apicoposterior segment of the left upper lobe was resected and continuously sutured. The pathologic diagnosis of the fatty mass was thymolipoma. The postoperative course was uneventful and discharged in good general conditions.

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A Case of Bronchitis and Bronchial Dysplasia Associated with Typhoid Fever (기관지염과 기관지 이형성이 동반된 장티푸스 1예)

  • Seok, Jun-Ho;Kim, Ki-Beom;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.227-233
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    • 1998
  • Typhoid fever is an acute systemic febrile disease caused by Salmonella typhi. The classic picture of the disease consists of prolonged continuous or remitting fever, abdominal pain, diarrhea, rose spots and delirium. Salmonella infection can lead to diffuse organ involvement., including bone, lung, thyroid, kidney, liver, spleen, heart, pericardium, intestine and skin and cause a variety of complications. Pulmonary manifestations occur in only 1 percent of the patients. Mild cough with sticky sputum is the earliest symptom and bronchitis, pneumonia and lung abscess were presented. Recently we experienced a case of typhoid fever complicated by bronchitis, dysplasia in a 37-year-old male physician who was improved with ceftriaxone and ciprofloxacin We report this case with a review of the literature.

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