Non-traumatic abdominal emergencies: imaging and intervention in sepsis.
Identifieur interne : 003505 ( Main/Exploration ); précédent : 003504; suivant : 003506Non-traumatic abdominal emergencies: imaging and intervention in sepsis.
Auteurs : RBID : pubmed:12195466English descriptors
- KwdEn :
- MESH :
- diagnosis : Abdominal Abscess.
- etiology : Abdominal Abscess.
- therapy : Abdominal Abscess.
- Diagnostic Imaging, Drainage, Emergencies, Female, Humans, Inhalation, Male, Radiography, Interventional.
Abstract
Cross-sectional imaging, in particular CT, has become the main method of detecting abdominal collections. Indium-labelled white-cell scintigraphy and gallium scintigraphy are reserved for patients in whom there is a high clinical suspicion of abdominal sepsis but CT has not revealed a source of sepsis. Scintigraphy is also used in patients with suspected vascular graft infections or suspected infected hip prostheses. Percutaneous abscess drainage (PAD) has revolutionised the treatment of abdominal abscesses over the past 20 years, with repeat laparotomy for postoperative abscesses becoming a rare event. Ultrasound or CT can be used to guide PAD. Choosing an access route that does not cross intervening organs is of crucial importance to the safe performance of PAD. The Trocar or Seldinger techniques can be used with equal success. The cavity should be aspirated until dry and irrigated with saline. Repeat imaging after drainage is helpful to detect any undrained locules. PAD endpoints include patient defervescence, reduction in white blood cell count and catheter drainage of less than 10 ml per day. Details regarding PAD in specific abdominal regions are discussed. Success rates for PAD are high (close to 90%) in most abdominal organs. Slightly lower success rates are seen with PAD of pancreatic abscesses and abscesses associated with fistulas (60-85% success rates). Complication rates lie between 0% and 10%. Complications can be minimised by ensuring that the patient has broad spectrum antibiotic coverage before drainage, by carefully planning the access route and by ensuring diligent post-procedure care by radiology staff.
DOI: 10.1007/s00330-002-1570-4
PubMed: 12195466
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Non-traumatic abdominal emergencies: imaging and intervention in sepsis.</title><author><name sortKey="Lee, Michael J" uniqKey="Lee M">Michael J Lee</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiology, Beaumont Hospital and the Royal College of Surgeons Medical, Beaumont Road, Dublin 9, Ireland. leebeau@iol.ie</nlm:affiliation><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Department of Radiology, Beaumont Hospital and the Royal College of Surgeons Medical, Beaumont Road, Dublin 9</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><date when="2002">2002</date><idno type="RBID">pubmed:12195466</idno><idno type="pmid">12195466</idno><idno type="doi">10.1007/s00330-002-1570-4</idno><idno type="wicri:Area/Main/Corpus">003683</idno><idno type="wicri:Area/Main/Curation">003683</idno><idno type="wicri:Area/Main/Exploration">003505</idno></publicationStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Abdominal Abscess (diagnosis)</term><term>Abdominal Abscess (etiology)</term><term>Abdominal Abscess (therapy)</term><term>Diagnostic Imaging</term><term>Drainage</term><term>Emergencies</term><term>Female</term><term>Humans</term><term>Inhalation</term><term>Male</term><term>Radiography, Interventional</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Abdominal Abscess</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Abdominal Abscess</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Abdominal Abscess</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Diagnostic Imaging</term><term>Drainage</term><term>Emergencies</term><term>Female</term><term>Humans</term><term>Inhalation</term><term>Male</term><term>Radiography, Interventional</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Cross-sectional imaging, in particular CT, has become the main method of detecting abdominal collections. Indium-labelled white-cell scintigraphy and gallium scintigraphy are reserved for patients in whom there is a high clinical suspicion of abdominal sepsis but CT has not revealed a source of sepsis. Scintigraphy is also used in patients with suspected vascular graft infections or suspected infected hip prostheses. Percutaneous abscess drainage (PAD) has revolutionised the treatment of abdominal abscesses over the past 20 years, with repeat laparotomy for postoperative abscesses becoming a rare event. Ultrasound or CT can be used to guide PAD. Choosing an access route that does not cross intervening organs is of crucial importance to the safe performance of PAD. The Trocar or Seldinger techniques can be used with equal success. The cavity should be aspirated until dry and irrigated with saline. Repeat imaging after drainage is helpful to detect any undrained locules. PAD endpoints include patient defervescence, reduction in white blood cell count and catheter drainage of less than 10 ml per day. Details regarding PAD in specific abdominal regions are discussed. Success rates for PAD are high (close to 90%) in most abdominal organs. Slightly lower success rates are seen with PAD of pancreatic abscesses and abscesses associated with fistulas (60-85% success rates). Complication rates lie between 0% and 10%. Complications can be minimised by ensuring that the patient has broad spectrum antibiotic coverage before drainage, by carefully planning the access route and by ensuring diligent post-procedure care by radiology staff.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">12195466</PMID><DateCreated><Year>2002</Year><Month>08</Month><Day>26</Day></DateCreated><DateCompleted><Year>2002</Year><Month>12</Month><Day>03</Day></DateCompleted><DateRevised><Year>2005</Year><Month>11</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">0938-7994</ISSN><JournalIssue CitedMedium="Print"><Volume>12</Volume><Issue>9</Issue><PubDate><Year>2002</Year><Month>Sep</Month></PubDate></JournalIssue><Title>European radiology</Title><ISOAbbreviation>Eur Radiol</ISOAbbreviation></Journal><ArticleTitle>Non-traumatic abdominal emergencies: imaging and intervention in sepsis.</ArticleTitle><Pagination><MedlinePgn>2172-9</MedlinePgn></Pagination><Abstract><AbstractText>Cross-sectional imaging, in particular CT, has become the main method of detecting abdominal collections. Indium-labelled white-cell scintigraphy and gallium scintigraphy are reserved for patients in whom there is a high clinical suspicion of abdominal sepsis but CT has not revealed a source of sepsis. Scintigraphy is also used in patients with suspected vascular graft infections or suspected infected hip prostheses. Percutaneous abscess drainage (PAD) has revolutionised the treatment of abdominal abscesses over the past 20 years, with repeat laparotomy for postoperative abscesses becoming a rare event. Ultrasound or CT can be used to guide PAD. Choosing an access route that does not cross intervening organs is of crucial importance to the safe performance of PAD. The Trocar or Seldinger techniques can be used with equal success. The cavity should be aspirated until dry and irrigated with saline. Repeat imaging after drainage is helpful to detect any undrained locules. PAD endpoints include patient defervescence, reduction in white blood cell count and catheter drainage of less than 10 ml per day. Details regarding PAD in specific abdominal regions are discussed. Success rates for PAD are high (close to 90%) in most abdominal organs. Slightly lower success rates are seen with PAD of pancreatic abscesses and abscesses associated with fistulas (60-85% success rates). Complication rates lie between 0% and 10%. Complications can be minimised by ensuring that the patient has broad spectrum antibiotic coverage before drainage, by carefully planning the access route and by ensuring diligent post-procedure care by radiology staff.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Michael J</ForeName><Initials>MJ</Initials><Affiliation>Department of Radiology, Beaumont Hospital and the Royal College of Surgeons Medical, Beaumont Road, Dublin 9, Ireland. leebeau@iol.ie</Affiliation></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType>Journal Article</PublicationType><PublicationType>Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2002</Year><Month>07</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Eur Radiol</MedlineTA><NlmUniqueID>9114774</NlmUniqueID><ISSNLinking>0938-7994</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N">Abdominal Abscess</DescriptorName><QualifierName MajorTopicYN="Y">diagnosis</QualifierName><QualifierName MajorTopicYN="N">etiology</QualifierName><QualifierName MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y">Diagnostic Imaging</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Drainage</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Emergencies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Inhalation</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Radiography, Interventional</DescriptorName></MeshHeading></MeshHeadingList><NumberOfReferences>33</NumberOfReferences></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2002</Year><Month>8</Month><Day>27</Day><Hour>10</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2002</Year><Month>12</Month><Day>4</Day><Hour>4</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="aheadofprint"><Year>2002</Year><Month>Jul</Month><Day>6</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2002</Year><Month>8</Month><Day>27</Day><Hour>10</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">12195466</ArticleId><ArticleId IdType="doi">10.1007/s00330-002-1570-4</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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