Publish in OALib Journal
APC: Only $99
Purpose: To determine diagnostic and therapeutic problems of pyogenic liver abscess in our hospital. Method and material: We conducted a retrospective study from January 2006 to December 2010 of all children aged from 0 - 15 years admitted and treated for pyogenic liver abscesses. Amoebic liver abscesses and other hepatobiliary disorders were not considered. Results: Pyogenic abscesses accounted for 50 cases. The mean age of patients at presentation was 2.4 ± 0.78 years (range from 6 months to 15 years). Sex ratio was 2.8 for boys. Abdominal pain was the primary reason for consultation in 27 cases (54%). Fever has been noted in 42 patients (84%) and the patient general state was altered in 13 patients (26%). Escherishia coli was the most frequent bacteria found at pus. The pus was sterile in 25 cases (50%). The ultrasonographic percutaneous drainage was performed in 33 patients (66%), open surgery in 6 (12%) and antibiotics alone in 11 others (22%). The short outcomes were simple in 36 patients (72%) while pain and fever persisted in 12 others (24%). Two patients (4%) died from sepsis soon after the operating room. Improving the frequency of early diagnosis will depend on education of clinicians about the need for clinical suspicion aided by ultrasound.
This prospective survey was conducted from February to December
2014 about the use ceftriaxone (ceftriaz) for antibioprophylaxy concerning 300
patients by the surgery staff in the Gabriel Touré Teaching Hospital in Mali.
The quantity of drug used was based on the weight of the patient. One dose was
administrated in intravenous at the anesthesiology induction time. For more
than 2 hours of intervention time, 4 (1.3%) patients received a second dose.
The majority of cases (189, 63%) were out of emergency (emergency cases—111,
37%). The mean age was 41.6 years (range: 3 - 95 years). The patients were
classed Altmeir II 203 (67.7%) and Altmeir I 97 (32.3%). The NNISS score 0
concerned 101 (33.6%) and NNISS 1 in 180 (60%) patients. The factors of risky
were anemia (38; 12.7%), diabetes (6; 2%), and HIV (3; 1%). The mean of intervention
duration was 56.8？±？27.5 minutes. Four cases of intervention site
infection were encountered caused by？Pseudomonas？aeruginosa？in 2 patients;？Escherichia coli？(1 case), and？Staphylococcus aureus？(1 case). Conclusion: Antibioprohylaxy is not the only way
to prevent infections but it stays necessary. The respect of hygien and aseptic
measures should be used to reduce the rate of intervention site infection.
Goal: To study the diagnostic
difficulties and post-operative morbidity and mortality of peritonitis.
Patients and Methods: Retrospective study about the records of adult patients
operated on between 1999 and 2013 whose diagnosis of post-operative peritonitis
was made. Results: We achieved
23,573 lanterns and recorded 148 cases of postoperative peritonitis or 0.62%.
The medium age was 37.1 ± 17.7 years and the sex ratio was 1.2. The delay
between the initial intervention and reoperation was less than 5 days. Factors
occurrence of postoperative peritonitis were those related to the initial surgery: septic context
70.8%, emergency surgery 81.1% under the seat mesocolic 25% and 20.3% initial
surgical technique. The diagnosis was made preoperatively in 62.2% (n = 92).
Ultrasound has found an effusion in 29.7% (n = 44). Cytobactériologic review
identified germs in 85.1% (n = 126) and sterile in 12.9% of patients (n = 22).
The most frequent etiologies were: 22.9% anastigmatic leak (n = 34), the
phoenix abscess in 17.6% (n = 26), iatrogenic perforation 13.5% (n = 20) and
digestive fistula 25% (n = 37). Other causes were the stoical necrosis 12.2% (n = 18) and evisceration 8.8% (n =
13). We performed a digestive stoma in 61% (n = 89), a closure of the abdomen
bolsters in 8.8% (n = 13), a suture in iatrogenic perforation in 13.5% (n = 20)
and washing with drainage in patients with phoenix abscess in 17.6% (n = 26).
Morbidity was 22.3% and 53.4% mortality. Conclusion: The diagnosis of
post-operative peritonitis is difficult in a developing
country. Morbidity and mortality is high. Improved diagnostic tools are