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【Objective】 To investigate the efficacy of flexible ureteroscopic holmium laser lithotripsy combined with cyst wall incision and drainage in the treatment of renal calculi with ipsilateral renal cyst. 【Methods】 A total of 70 patients with renal calculi complicated with ipsilateral renal cyst (cyst diameter >40 mm, maximum diameter of stone 0.05). 【Conclusion】 Flexible ureteroscopic holmium laser lithotripsy combined with cyst incision and drainage has the advantages of short operation time, small trauma, few adverse reactions, good stone clearance effect and satisfactory efficacy. It can be used as a preferred surgical method for renal calculi complicated with ipsilateral renal cyst.
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Granulomatous mastitis is a chronic inflammatory condition of the breast that is rarely described in literature. It mimics breast abscess on clinical presentation giving dilemma to the surgeon. The etiology can be infectious, autoimmune or idiopathic. The various modalities of treatment for idiopathic granulomatous mastitis includes drainage of abscess, antibiotics and corticosteroid therapy. This is a case series of ten cases of diagnosed with granulomatous mastitis treated in the period of 2 years from 2018 and 2019 in Department of General Surgery, MGM Hospital Navi Mumbai. The data of all the patients were collected from records. They were following at regular intervals in the outpatient department to assess recurrence. The mean age of the patients was 41 years (range 26–47 years). Six patients gave history of breast-feeding in the last 5 years, one was lactating at the time of presentation. One of the patients was treated empirically for Tuberculous mastitis for the opposite breast. Others had no history suggestive of tuberculosis or other connective tissue diseases, such as rheumatoid arthritis or sarcoidosis USG breast was performed in all cases. Hypoechoic abscess was seen in 5 cases. The time taken for complete resolution of the disease was ranging from 2 weeks to 2 months. All patients had an uneventful recovery and no recurrences reported till now. GM is a rare benign breast disease that is difficult to distinguish from other inflammatory breast diseases or cancer. The diagnosis of GM must be based on a multidisciplinary approach. Surgical management followed by antibiotics was found to be sufficient to treat the condition in our patients. Corticosteroids need not be administered in all cases of this benign breast disease.
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OBJECTIVE@#This study aims to observe the efficacy of vacuum sealing drainage (VSD) by continuous negative pressure drainage and saline irrigation in the treatment of oral and maxillofacial space infection.@*METHODS@#Retrospective analysis was conducted on 116 cases of maxillofacial space infection, and clinical data were collected to compare the therapeutic effects of routine incision with drainage treatment (traditional treatment group, 58 cases) and VSD treatment (VSD group, 58 cases).@*RESULTS@#The length of hospital stay, white blood cell count, scar length, frequency of dressing change, and pain degree of patients in the VSD group were all lower than those in the traditional treatment group. Moreover, the improvement degree of mouth opening in the VSD groups was better than that in the traditional treatment group (P<0.05).@*CONCLUSIONS@#VSD is a more effective method for the treatment of oral and maxillofacial space infection.
Subject(s)
Humans , Body Fluids , Drainage , Mouth Diseases , Therapeutics , Retrospective Studies , Surgical Wound Infection , Therapeutics , VacuumABSTRACT
El hematoma vulvar es la colección de sangre a nivel vulvar. Generalmente es secundario a un trauma obstétrico, lesiones por contusión o relaciones sexuales consensuadas. Se presenta una paciente de 21 años de edad que acude a esta unidad de salud en el mes de enero de 2017, refiriendo que posterior a un acto sexual comenzó a presentar aumento progresivo de volumen de vulva, acompañado de dolor y de dificultad para la deambulación. Se realizó incisión y drenaje del hematoma, se dan puntos hemostáticos, se colocó drenaje y se inició terapia antimicrobiana con ceftriaxone y metronidazol. El hematoma vulvar de la magnitud presentada constituyó una urgencia quirúrgica por el compromiso de la funcionalidad del aparato genitourinario. El drenaje del hematoma y la indicación de antimicrobianos permitió su evolución satisfactoria(AU)
The vulvar hematoma is the collection of blood in the vulvar area. It is usually secondary to obstetric trauma, contusion injuries or consensual sexual relations. We present a 21-year-old patient who came to this health unit in January 2017, reporting that after a sexual intercourse, she began to present a progressive increase in vulvar volume, pain and difficulty in walking. The hematoma was incised and drained, hemostatic stitches were given, drainage was placed and ceftriaxone and metronidazole were the antimicrobial therapy of choice. The vulvar hematoma of this magnitude was a surgical emergency due to the compromised functionality of the genitourinary system. The drainage of the hematoma and the indication of antimicrobials allowed satisfactory evolution(AU)
Subject(s)
Humans , Female , Adult , Vulvar Diseases/blood , Hematoma/drug therapy , Hematoma/surgeryABSTRACT
Objective To evaluate the clinical characteristics and the clinical outcomes of perianal abscess (PA) in neonates.Methods A retrospective review was performed on the collected data of 185 patients of PA in neonates prospectively admitted to Binzhou Medical University Hospital from January 2008 to December 2015.Patients were divided into 2 groups on the parents' intention:nonsurgical treatment and surgical treatment,the standard surgical treatment for PA was incision and drainage with the use of packing.The standard surgical treatment for PA was surgical incision drainage of lower abscess under local anesthesia by the use of filling tamponade iodoform gauze,while the patients receiving conservative treatment took hip bath perianally with topical 1 ∶ 5 000 potassium permanganate,besmearing erythromycin eye ointment outside locally.Incision-thread-drawing procedure was recommended in fistula-in-ano (FIA) after 6 months.Antibiotics were administered in all patients in the early days.The clinical data of age,gender,accompanying diseases,abscess amount and location,treatment approach,healing time and recurrence rates were analyzed with statistical method.Results All patients were boys,time of visiting hospital was 1-25 day,the average time 7.5 days;60 cases (32.4％)had neonatal diarrhea,45 cases (24.3％)had neonatal jaundice,but no patients had severe fever.A single skin lesion was present in 145 patients (78.4％),2 lesions in 30 patients (16.2％),and 10 patients had 3 lesions (5.4％).The most commonly affected sites were at 9 o'clock clockwise direction with 115 (62.2％)lesions on lithotomy position,followed by 3 o'clock clockwise direction with 65(35.1％) lesions by 1 o'clock clockwise direction with 3 (1.6％) lesions and 6 o'clock clockwise direction with 2 (1.1％) lesions.Bacteria cultures were obtained from 123 patients (90.4％,123/136 cases) of surgical treatment and 35 patients (71.4％,35/49 cases) of nonsurgical treatment obtained the results of bacteria culture.The average healing time was (21 ±2) days (10-60 days) in the surgical treatment group,and (36 ± 3) days (9-90 days) in the nonsurgical treatment group,7 out of 136(5.1％) patients had a recurrence with surgical treatment,incision drainage was performed again with the use of packing,and FIA was not found,10 out of 49 (20.4％) patients had a recurrence with nonsurgical treatment group,and 6 out of 49 (12.2％) were spontaneously resolves within the first year of life,4 out of 49 (8.1％) developed into FIA,incision-thread-drawing procedure was performed after 6 months.The significant difference was observed between and nonsurgical treatment and surgical treatment in healing time (t =-6.707,P =0.000),recurrence (x2 =11.347,P =0.001) and FIA formation rate (x2 =10.054,P=0.002).Conclusions PA is an entity in neonates.Incision and drainage of PA is an effective and safe therapy in the early days.Surgery for PA may result in low recurrence rates,a low rate of evolution toward FIA,and a short healing time,which should be considered as the primary treatment.The key procedure is to keep the drainage unobstructed by the use of filling gauze drainage to prevent crissum abscess recurrence.Postoperative care with antibiotics is effective to shorten hospital stays.
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PURPOSE: To report a case of Descemet's membrane detachment and corneal edema caused by an iatrogenic corneal perforation created while performing a local anesthetic (lidocaine) injection into the eyelid for a hordeolum incision and a drainage procedure. The detachment resolved after 14% C₃F₈ gas and air injections into the anterior chamber. CASE SUMMARY: An 8-year-old female visited our clinic after the onset of severe pain and decreased visual acuity while receiving a local anesthetic injection into the upper eyelid in preparation for a hordeolum incision and drainage procedure. Corneal optical coherence tomography (OCT) showed Descemet's membrane detachment. Three days after the first visit, the corneal epithelium had entirely healed. However, Descemet's membrane detachment persisted even after three weeks of follow-up. A corneal OCT was repeated after three weeks and showed a partial Descemet's membrane rupture. A more aggressive treatment method was deemed necessary, and gas and air injections into the anterior chamber were performed. After 48 hours, aside from some Descemet's membrane rolling at the site of rupture, overall reattachment of Descemet's membrane was noted. After three months of follow-up, the patient showed a stable corneal state and normalized vision. CONCLUSIONS: Descemet's membrane detachment and rupture resulting from an iatrogenic corneal perforation during an injection of lidocaine to the eyelid led to decreased visual acuity from corneal edema. As a more aggressive treatment method, 14 % C₃F₈ gas and air injections into the anterior chamber were performed and resulted in near complete reattachment of Descemet's membrane's and normalization of the patient's visual acuity.
Subject(s)
Child , Female , Humans , Anesthesia, Local , Anterior Chamber , Corneal Edema , Corneal Perforation , Descemet Membrane , Drainage , Epithelium, Corneal , Eyelids , Follow-Up Studies , Hordeolum , Lidocaine , Methods , Rupture , Tomography, Optical Coherence , Visual AcuityABSTRACT
Objective To investigate the effect of hyperbaric oxygen therapy on serum procalcitonin (PCT), white blood cells(WBC) and high-sensitivity C-reactive protein (hs-CRP) levels in children with necrotising fasciitis (NF) and its efficacy, and explore the diagnosis value of above indicators.Methods From March 2011 to June 2014,50 cases children with acute necrotic fasciitis treated in Children's Hospital of Hebei Province as study group,which were randomly divided into hyperbaric oxygen group (n =25) and routine group (n =25) .The routine group received the routine therapy of incision and drainage to clear the lesion, hyperbaric oxygen group received hyperbaric oxygen therapy on the basis of routine group,while 50 healthy children were selected as control group.The serum PCT, WBC, hs-CRP levels, efficacy, complications, death and hospitalization time were observed and compared.Results The serum PCT, WBC and hs-CRP levels pre-treatment in study group were higher than those in control group(P<0.05).The area under the ROC curve of PCT and hs-CRP was 1.000,respectively, and WBC was 0.804, there were significant difference between PCT and WBC (Z=5.250,P=0.000), between hs-CRP and WBC (Z=5.037,P=0.000).After treatment, the wounds of 23 case patients (92.00%) were cured in hyperbaric oxygen group, and 21 cases in routine group (84.00%) , there were no significant difference in cure rate between two groups.There were six cases(24.00%) of complications and one case (4.00%) of death in hyperbaric oxygen group,while nine cases (36.00%) of complications and two cases (8.00%) of death, there were no significant difference in complications rate and death rate between two groups.The hospitalization time in hyperbaric oxygen group was (39.17 ±6.73) d, which was significantly lower than (52.13 ±4.28) d in routine group(P<0.05).Conclusion PCT and hs-CRP have certain value in diagnosis of children with acute necrotizing fasciitis; incision and drainage combined with hyperbaric oxygen therapy has a better clinical effect in the treatment of children with acute necrotizing fasciitis.
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Background and objectives: Peritonsillar abscess (quinsy) is the most common deep infection of the head and neck. The surgical treatment whether abscess tonsillectomy or interval tonsillectomy should be done is a subject of controversy, which still remains unresolved. Setting: Dept. of ENT, Head and Neck Surgery, KVG Medical College, Sullia, Karnataka. Material and methods: This was a comparative case series analysis study done in our department during the study period of 54 months from January 2007 to June 2011. Twenty-seven patients with clinical features of peritonsillar abscess who underwent medical line of treatment with incision and drainage and later interval tonsillectomy were included in the study. Results: The mean age was 30.4 years, mean hospital stay during incision and drainage was 3.51 days. The patient turned up for surgery within a mean duration of 9.4 months. The mean blood loss during the procedure was 100.5 ml and the mean visual analog scale (VAS) scores after interval tonsillectomy were 4.78. Mild-to-moderate difficulty was seen during the dissection of the abscess scarred tonsillar bed. Conclusion: Interval tonsillectomy is the standard treatment for managing peritonsillar abscess in many institutions. We recommend interval method of tonsillectomy done after a minimum of six weeks after incision and drainage of the peritonsillar abscess.
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Heel abscesses present as heel pain that progressively worsens, with associated tenderness and fullness a the heel pad. To our knowledge, there are fews reports in the literature describing a spontaneous heel pad abscess. A 48-years old woman presented spontaneously with pain, erythema, edema and increased warmth to this right foot. She has no underlying disease and steroid injection history. A radiologic examination was suggestive of an abscess. Follow incision and drainage, cultures that were taken during the surgical procedure did not produce any organism. The patient was discharged home and recovered from the abscess without recurrence or further surgical intervention.
Subject(s)
Female , Humans , Abscess , Drainage , Edema , Erythema , Foot , Heel , RecurrenceABSTRACT
It is well known that the thyroid gland is resistant to infection due to its anatomic and physiological characteristics. Thyroid abscess in an adult is extremely rare. It is more commonly found in children than in adults. The treatment goal of this disease is to eliminate the source of infection by incision and drainage, or by a thyroidectomy and administration of antibiotics, depending on the clinical findings.We report a case of thyroid abscess found in a 29-year-old woman. The patient presented with a painful mass in the left thyroid for 6 days duration. The patient had a history of subacute thyroiditis that was treated with steroidsand thyroid hormone. Computed tomography showed a large, fluid contained, cystic predominant mass in the left thyroid. Aspiration of the cystic fluid confirmed the presence of the thyroid abscess. Under local anesthesia, an incision and drainage was performed. The patient improved dramatically after surgery and the patient was discharged 8 days later.
Subject(s)
Adult , Child , Female , Humans , Abscess , Anesthesia, Local , Anti-Bacterial Agents , Drainage , Thyroid Gland , Thyroidectomy , Thyroiditis, SubacuteABSTRACT
PURPOSE: The results of surgical treatment for acute suppurative cervical lymphadenitis in children were evaluated with literature reviews. METHODS: Children under 15-year old who required operative management for acute suppurative cervical lymphadenitis between January 1996 and December 2000 were evaluated with retrospective manner. The clinical characteristics, pathologic results and microbiologic studies were reviewed. RESULTS: 37 patients were treated with surgical methods. 36 patients recovered fully after surgical intervention without any recurrence and one patient expired of sepsis. CONCLUSION: The classical treatment, incision and drainage, is one of the treatment of choice for the recovery from suppurative cervical lymphadenitis in children.
Subject(s)
Adolescent , Child , Humans , Drainage , Lymphadenitis , Recurrence , Retrospective Studies , SepsisABSTRACT
BACKGROUND: Peritonsillitis is a clinical condition of gross tonsillar infection in a septic patient with localized swelling in the peritonsillar region, and which encompasses both peritonsillar abscess and cellulitis. It is not rarely experienced in spite of decreasing incidence since the advent of antibiotic therapy. OBJECTIVES: Our objective was a clinical observation of many factors in relation to peritonsillitis. MATERIALS AND METHODS: A clinical observation was performed on 40 cases with peritonsillitis, who visited St. Benedict hospital during 3 years from February 1994 to March 1997. A needle aspiration was attempted at the point of maximum bulging using a 10cc syringe with an 18-gauge needle. RESULTS: Among 40 cases, 23 cases yielded pus. From those 23 cases, we could isolate 22 strains in 20 cases. Incision and drainage was performed only in cases of aspiration of pus(23 cases). There was no significant difference in duration of hospitalization between I & D group(7.17 days) and non-I & D group(6.71 days)(p>0.05). CONCLUSION: We conclude that I & D can't reduce the duration of hospitalization even though I & D is helpful for the relief of symptoms, and the adequate use of antibiotics is important for the treatment of peritonsillitis.