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Lesser Sac Abscess

Abdominal Abscess Lesser Sac


Presentation

  • Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s) Distant metastasis (M) MX Presence of distant metastasis cannot be assessed M0 No distant metastasis Ml Distant metastasis present[books.google.com]
  • A high fever is present in the initial stages but in severe peritonitis there may be hypothermia. Tachycardia is usually present. The classic abdominal signs are tenderness on palpation, guarding and rebound tenderness.[patient.info]
  • That is why the clinical presentation of posterior gastric perforation is less dramatic than that of the more common anterior perforations and is characterized by late presentation.[ejs.eg.net]
  • Presents numerous recesses into which pus from an abscess may be drained. Subphrenic (suprahepatic) recess Is a peritoneal pocket between the diaphragm and the anterior and superior part of the liver.[wikiradiography.net]
  • Article Access Statistics Viewed 5925 Printed 104 Emailed 3 PDF Downloaded 17 Comments 2 Scrotal swelling and normal lipase, a rare presentation of acute pancreatitis: a literature review and case report Wahib Zafar,Ben Chaucer,Fidencio Davalos,Jay Nfonoyim[jpgmonline.com]
Fever
  • Abstract A 76-year-old man was emergently seen at the hospital because of upper abdominal pain and fever. Abdominal CT scan showed a low density mass measuring 14 cm in maximum diameater in the peritoneal cavity.[jstage.jst.go.jp]
  • No fever of leukocytosis.[aast.org]
  • Symptoms may include fever, pain anywhere in the abdomen, diarrhoea or ileus. A subphrenic abscess can cause chest pain and also shoulder pain. Psoas muscle abscesses may lead to flank pain which radiates to the groin.[patient.info]
  • With generalised peritonitis, the patient is very unwell, with marked fever, tachycardia and dehydration. There is diffuse abdominal pain, exacerbated by even the slightest movement.[surgwiki.com]
  • The patient did not have fever. The collection underwent successful percutaneous drainage, which showed clear fluid with high amylase and subsequently resolved along with the patient's symptoms.[radiologyassistant.nl]
Malaise
  • TUBERCULOUSPERITONITIS Acute and chronic forms Abdominal pain, sweats, malaise and weight loss arefrequent Caseating peritoneal nodules are common – distinguishfrom metastatic carcinoma and fat necrosis of pancreatitis Ascites common, may be loculated[slideshare.net]
  • Pain usually begins as para-umbilical discomfort, accompanied by malaise, and diarrhoea or constipation.[bmb.leeds.ac.uk]
Goiter
  • Endemic goiter is mainly seen in areas like mountainous regions, flood planes which lacks iodine in the soil.[flashcardmachine.com]
Abdominal Pain
  • Abstract A 76-year-old man was emergently seen at the hospital because of upper abdominal pain and fever. Abdominal CT scan showed a low density mass measuring 14 cm in maximum diameater in the peritoneal cavity.[jstage.jst.go.jp]
  • […] with free intra-abdominal fluid Transmural colonic inflammation IV Localized colonic necrosis, with or without perforation Abdominal pain with peritonitis and mucosal necrosis by endoscopy Colonic thickening with free fluid /- evidence of perforation[aast.org]
  • Journal of Clinical Gastroenterology: June 1981 Clinical Studies: PDF Only Abstract In a 45-year-old woman with abdominal pain and vomiting, plain films and barium studies showed a gas and fluid collection displacing the stomach anteriorly and to the[journals.lww.com]
  • […] changed the epidemiology of abdominal pain in HIV/AIDS patients. ( 22 ) Presentation with acute abdominal pain occurs in 12-48% of HIV patients.[ptolemy.ca]
  • Peritonitis The principal feature is abdominal pain.[patient.info]
Acute Abdomen
  • CONCLUSION: The early diagnosis of acute intestinal obstruction and immediate indication for laparotomy is the main task of the surgeon when faced with a case of acute abdomen with a hypothesis of internal hernia, so as to minimize severe postoperative[ingentaconnect.com]
  • Diagnosis – the acute abdomen Abdominal pain is the most common reason for admission to hospital in the USA and correct diagnosis of the acute abdomen remains a challenge for physicians. ( 18 ) Acute abdominal pain is defined as acute undiagnosed pain[ptolemy.ca]
Upper Abdominal Pain
  • Abstract A 76-year-old man was emergently seen at the hospital because of upper abdominal pain and fever. Abdominal CT scan showed a low density mass measuring 14 cm in maximum diameater in the peritoneal cavity.[jstage.jst.go.jp]
  • Esophageal Perforation AAST Grade Description Clinical Criteria Imaging and/or endoscopic criteria Operative Criteria Pathologic criteria I Mucosal tear Dysphagia; chest pain, upper abdominal pain or back pain; breathing problems No abnormality or possible[aast.org]
Peritoneal Disease
  • disease): 38 (77.5%) Lymph nodes: 23 (46.9%) G.I.T: 19 (38.7%) Solid organ involvement: 10 (20.4%) Table 3 CT features of Peritoneal TB (n 38; wet 21; dry 17) Free Loculated Free Loculated LV SV LV SV LV SV LV SV 3 2 6 2 5 1 1 1 Lymphnode involvement[bmcmedimaging.biomedcentral.com]
Epigastric Mass
  • Physical examination revealed a firm, epigastric mass that did not move with respiration. Her computed tomography (CT) scan report showed a lobulated, cystic mass lesion in the lesser sac of size 10 cm 9 cm 8 cm ( [Figure 1] ).[journalofmas.com]

Workup

  • (See Workup, Computed Tomography.) Sequential, multiple organ failure is the main cause of death.[emedicine.medscape.com]

Treatment

  • She had undergone a previous conservative treatment for acute pancreatitis in a therapeutic ward.[press.mu-varna.bg]
  • Treatment The recurring themes of treatment in peritonitis are: a) resuscitation, b) antibiotics, c) peritoneal lavage, and d) source control 4.2.1.[ptolemy.ca]
  • The treatment of subphrenic abscess is that of any intra-abdominal abscesses. The treatment of sealed perforated ulcer is non operative.[oatext.com]
  • A summary of the advantages and disadvantages of the various treatment strategies discussed is included in Table 1.[pancreas.imedpub.com]
  • Delayed diagnosis and treatment can also lead to increased mortality; therefore, the economic impact of delaying treatment is significant.[emedicine.medscape.com]

Prognosis

  • Prognosis Abscess The prognosis has improved considerably with the advent of drainage under CT scanning. Deaths are generally due to the underlying disease process or unsuspected foci of infection.[patient.info]
  • The prognosis of the affected batch depends on how often and how severe is the condition.[marcosgodoy.com]
  • Prognosis The introduction of computed tomography (CT) for the diagnosis and drainage of intra-abdominal abscesses has led to a dramatic reduction in mortality. (See Workup, Computed Tomography.)[emedicine.medscape.com]

Etiology

  • Helicobacter pylori is not the predominant etiology for peptic ulcers requiring operation. Am Surg 2011; 77:1054-1060. 2. Bertleff MJ, Lange JF. Perforated peptic ulcer disease: a review of history and treatment. Dig Surg 2010; 27:161-169. 3.[ejs.eg.net]
  • Etiology Although multiple causes of intra-abdominal abscesses exist, the following are the most common: Perforation of viscus, which includes peptic ulcer perforation [2] Perforated appendicitis and diverticulitis Gangrenous cholecystitis Mesenteric[emedicine.medscape.com]
  • The retrospective/prospectiv e study was analyzed by etiological forms with speci fic therapeutic management, and timing of surgery was analyzed with the benchmark of 21 day according to the studies of Fernández del Cas- tillo [8] and recommendations[file.scirp.org]
  • The etiology of chronic active hepatitis is usually idiopathic but may be viral or immunological.[flashcardmachine.com]
  • Etiology/Epidemiology A wide variety of disease states give rise to intra-abdominal infection. ( 4 ) While varying according to age, gender and geography, the three most common causes of generalized peritonitis in low-income countries are probably appendicitis[ptolemy.ca]

Epidemiology

  • Time-trends in the epidemiology of peptic ulcer bleeding. Scand J Gastroenterol. 2005; 40 :914–20. 3. Sharma SS, Mamtani MR, Sharma MS, Kulkarni H.[tropicalgastro.com]
  • Epidemiology The incidence depends on the cause. In a hospital setting the prevalence of SBP is around 10%. [ 3 ] Three studies of patients with perforated appendicitis found an incidence of postoperative abscess formation of 20%.[patient.info]
  • Systematic review of the epidemiology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality. Digestion 2011; 84:102-113. 4. Williams N, Bullstrode C, Connell RO.[ejs.eg.net]
  • Epidemiology and pathophysiology of intraabdominal infections (IAI). [Review] [26 refs]. Infection 26(5):329-34, 1998;-Oct. (15) Laroche M, Harding G. Primary and secondary peritonitis: an update. [Review] [79 refs].[ptolemy.ca]
  • Radiology 226: 556–557 PubMed CrossRef Google Scholar Van Breda Vriesman AC, Lohle PNM, Coerkamp EG, Puylaert JBCM (1999) Infarction of omentum and epiploic appendage: diagnosis, epidemiology and natural history.[link.springer.com]
Sex distribution
Age distribution

Pathophysiology

  • Associated pathophysiologic effects may become life threatening or lead to extended periods of morbidity with prolonged hospitalization.[emedicine.medscape.com]
  • Pathophysiology Peritonitis is an inflammatory response to peritoneal injury.[ptolemy.ca]

Prevention

  • Foley Catheter Enterostomy First, the proper size of the ballooning could obstruct the leakage site, and it is easy to prevent local fluid collection. Also, it is possible to form the fistula tract faster than in a simple procedure.[apscvir.com]
  • Actual passage of infectious material into the peritoneum, however, is rare due to the presence of a mucous plug in the external os (opening) of the uterus which prevents the passage of pathogens but allows sperm to enter the uterus.[teachmeanatomy.info]
  • In abdominal wounds the omentum may protrude, block up the opening, and so prevent the escape of blood. Fig. 24.- Diagram of Peritoneum, its Sacs and Folds. Lesser sac is shaded. Arrow through foramen of Winslow.[bookdome.com]
  • Source control, reduction in bacterial contamination and prevention of its recurrence are the hallmarks of surgical treatment.[ptolemy.ca]
  • We use these foils 5-6 days after surgical intervention when the wounds begin to granulate to prevent suppura- tive complications of the abdominal wall.[file.scirp.org]

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