BACKGROUND Pyogenic liver abscesses are insidious in the early stage.Some cases progress rapidly,and the patient’s condition can worsen and even become life-threatening if timely treatment is not provided.Surgery and...BACKGROUND Pyogenic liver abscesses are insidious in the early stage.Some cases progress rapidly,and the patient’s condition can worsen and even become life-threatening if timely treatment is not provided.Surgery and prolonged antibiotic treatment are often required if the abscess is large and liquefied and becomes separated within the lumen.CASE SUMMARY We report a case of bacterial liver abscess with a poor outcome following pharmacological treatment,review the literature related to the use of platelet-rich plasma(PRP)in the treatment of hepatic impairment and partial hepatectomy in animals,and discuss the prognostic features of surgical incision and drainage combined with PRP in the treatment of bacterial liver abscesses.This is the first case describing the use of PRP in the treatment of a bacterial liver abscess in humans,providing new ideas for the treatment of this condition.CONCLUSION This case highlights the importance of surgical treatment for bacterial liver abscesses that are well liquefied and poorly managed medically.PRP may produce antimicrobial effects and promote the regeneration and repair of liver tissue.展开更多
Background:Incision and drainage(I&D)for perianal abscesses is associated with high rates of fistula formation.Our study aimed to evaluate the effectiveness of a novel technique,trans-intersphincteric double seton...Background:Incision and drainage(I&D)for perianal abscesses is associated with high rates of fistula formation.Our study aimed to evaluate the effectiveness of a novel technique,trans-intersphincteric double seton(TRISDS),designed to preserve anal sphincter integrity and improve clinical outcomes compared to I&D.Methods:This prospective,randomized,non-blinded controlled study included adult patients with perianal abscesses located below the levator ani muscle with an internal opening.Patients were randomly assigned to either the TRISDS group(n=55)or the I&D group(n=51).The TRISDS technique involved two incisions:intersphincteric and drainage incisions with the placement of two loose setons.One seton was positioned to preserve the internal anal sphincter and facilitate drainage through the intersphincteric space,while the other seton aimed to protect the external anal sphincter to ensure comprehensive drainage.The I&D group underwent conventional I&D without damaging the anal sphincter complex.The primary outcome was the cure rate of perianal abscesses,which was defined as complete epithelialization of wounds without fistula or exudate and no recurrence within 12 months after surgery.Results:The TRISDS group achieved a significantly higher cure rate of 78.2%(43/55)compared to 41.2%(21/51)in the I&D group(P<0.05).There were no significant differences in anal function at 2 months postoperatively between the groups(median Wexner score,IQR:1.0[0.0-1.0]vs 1.0[0.0-1.0],P>0.05).Conclusions:The study highlighted the effectiveness of TRISDS in improving cure rate without compromising anal function.The TRISDS technique represents a promising strategy for the treatment of perianal abscesses.Further multicenter studies are recommended to validate these findings and expand the application of TRISDS in diverse patient populations.展开更多
Objective:To review the clinical findings in deep neck infections and identification predisposing factors of these complications. Methods:In this study, 270 patients with deep neck infections were studied retrospectiv...Objective:To review the clinical findings in deep neck infections and identification predisposing factors of these complications. Methods:In this study, 270 patients with deep neck infections were studied retrospectively, study conducted in the Department of Ear, Nose and Throat, Dr. Shankarrao Chavan Govern-ment Medical College, Nanded, Maharashtra, India, from March 2013 to March 2016. Results:Analysis showed that males are most likely to have deep neck space infections (DNSI). Odontogenic and tonsillar causes were the more frequent ones. Staphylococcus aureus and Streptococcus species were the microorganisms more commonly isolated. Conclusion:DNSI remains a common and challenging disease for otorhinolaryngologists, and should be treated on emergency basis. In developing countries, lack of adequate nutrition, poor oral hygiene, tobacco chewing, smoking and beetle nut chewing has led to an increased prevalence of dental and periodontal diseases. In present study, Odontogenic infections were the most common etiological factor for DNSI.展开更多
基金Supported by Science and Technology Planning Project of Gansu Province,No.21CX6FD163Science and Technology Planning Project of Baiyin City,No.2021-1-18Y.
文摘BACKGROUND Pyogenic liver abscesses are insidious in the early stage.Some cases progress rapidly,and the patient’s condition can worsen and even become life-threatening if timely treatment is not provided.Surgery and prolonged antibiotic treatment are often required if the abscess is large and liquefied and becomes separated within the lumen.CASE SUMMARY We report a case of bacterial liver abscess with a poor outcome following pharmacological treatment,review the literature related to the use of platelet-rich plasma(PRP)in the treatment of hepatic impairment and partial hepatectomy in animals,and discuss the prognostic features of surgical incision and drainage combined with PRP in the treatment of bacterial liver abscesses.This is the first case describing the use of PRP in the treatment of a bacterial liver abscess in humans,providing new ideas for the treatment of this condition.CONCLUSION This case highlights the importance of surgical treatment for bacterial liver abscesses that are well liquefied and poorly managed medically.PRP may produce antimicrobial effects and promote the regeneration and repair of liver tissue.
基金the Chinese Clinical Trial Registry(ChiCTR2000032941)the Medical Ethics Committee of the Affiliated Hospital of Jiangxi University of Chinese Medicine(JZFYKYLL20200420007).
文摘Background:Incision and drainage(I&D)for perianal abscesses is associated with high rates of fistula formation.Our study aimed to evaluate the effectiveness of a novel technique,trans-intersphincteric double seton(TRISDS),designed to preserve anal sphincter integrity and improve clinical outcomes compared to I&D.Methods:This prospective,randomized,non-blinded controlled study included adult patients with perianal abscesses located below the levator ani muscle with an internal opening.Patients were randomly assigned to either the TRISDS group(n=55)or the I&D group(n=51).The TRISDS technique involved two incisions:intersphincteric and drainage incisions with the placement of two loose setons.One seton was positioned to preserve the internal anal sphincter and facilitate drainage through the intersphincteric space,while the other seton aimed to protect the external anal sphincter to ensure comprehensive drainage.The I&D group underwent conventional I&D without damaging the anal sphincter complex.The primary outcome was the cure rate of perianal abscesses,which was defined as complete epithelialization of wounds without fistula or exudate and no recurrence within 12 months after surgery.Results:The TRISDS group achieved a significantly higher cure rate of 78.2%(43/55)compared to 41.2%(21/51)in the I&D group(P<0.05).There were no significant differences in anal function at 2 months postoperatively between the groups(median Wexner score,IQR:1.0[0.0-1.0]vs 1.0[0.0-1.0],P>0.05).Conclusions:The study highlighted the effectiveness of TRISDS in improving cure rate without compromising anal function.The TRISDS technique represents a promising strategy for the treatment of perianal abscesses.Further multicenter studies are recommended to validate these findings and expand the application of TRISDS in diverse patient populations.
文摘Objective:To review the clinical findings in deep neck infections and identification predisposing factors of these complications. Methods:In this study, 270 patients with deep neck infections were studied retrospectively, study conducted in the Department of Ear, Nose and Throat, Dr. Shankarrao Chavan Govern-ment Medical College, Nanded, Maharashtra, India, from March 2013 to March 2016. Results:Analysis showed that males are most likely to have deep neck space infections (DNSI). Odontogenic and tonsillar causes were the more frequent ones. Staphylococcus aureus and Streptococcus species were the microorganisms more commonly isolated. Conclusion:DNSI remains a common and challenging disease for otorhinolaryngologists, and should be treated on emergency basis. In developing countries, lack of adequate nutrition, poor oral hygiene, tobacco chewing, smoking and beetle nut chewing has led to an increased prevalence of dental and periodontal diseases. In present study, Odontogenic infections were the most common etiological factor for DNSI.
