Urinary tract infection with renal abscess

Renal abscess is very rare among intra-abdominal abscesses in children. Ascending infection is the most common cause in children compared to hematogenous spread in adults and Escherichia coli is the main pathogen. Persisting high-grade fever is an alarming sign to intervene and has to be taken care of. Here, we are presenting the case of a 3-year-old boy with Klebsiella urinary tract infection and E. coli renal abscess of 4 cm size. Contrast-enhanced computed tomography abdomen helped in early intervention and management. The child responded very well to parenteral antibiotics and ultrasound-guided percutaneous aspiration.

Técnicas percutáneas con ozono en el quiste facetario lumbar: serie de casos / Percutaneous treatment with ozone for the treatment of the lumbar facet joint cyst: a case series

Los quistes sinoviales de las articulaciones facetarias lumbares son intraespinales, pero extradurales. Estos quistes extradurales pueden localizarse en el ligamento intraespinoso, la articulación facetaria, el ligamento amarillo o el ligamento longitudinal anterior. Aparecen más comúnmente en la cuarta o quinta décadas de la vida y son más frecuentes en la mujer que en el hombre. Se han publicado muchas alternativas de tratamiento contra los quistes facetarios, incluidos el seguimiento, la inyección de esteroides, la aspiración percutánea del quiste, la hemilaminectomía o laminectomía bilateral con o sin fijación y la incisión mínimamente invasiva. El objetivo de este trabajo fue describir la evolución clínica y anestesiológica de una serie de pacientes con quistes facetarios, quienes recibieron tratamiento médico con ozono, sin necesidad de intervención quirúrgica. Se presentó la evolución clínica de dos pacientes a los que se les aspiró sus respectivos quistes facetarios y se les inyectó ozono. Una de ellos recidivó y se le aplicó igual tratamiento, cuya evolución ha sido satisfactoria hasta el momento. La aspiración percutánea de los quistes facetarios es un procedimiento eficaz y de mínima invasión, evita la intervención quirúrgica en la columna y la evolución es satisfactoria(AU)

Synovial cysts of the lumbar facet joints are intraspinal, but extradural. These extradural cysts can be located in the intraspinal ligament, the facet joint, the yellow ligament or the anterior longitudinal ligament. They occur more commonly in the fourth or fifth decades of life and are more frequent in women than they are in men. Many treatment alternatives for facet joint cysts have been published, including follow-up, steroid injection, percutaneous cyst aspiration, bilateral hemilaminectomy or laminectomy with or without fixation, and minimally invasive incision. The aim of this study was to describe the clinical and anesthesiological evolution of a series of patients with facet joint cysts, who received medical treatment with ozone, without the need for surgical intervention. The clinical evolution was presented of the two patients who were aspirated their respective facet joint cysts and injected with ozone. One of them relapsed and was given the same treatment, and whose evolution has been satisfactory so far. Percutaneous aspiration of facet joint cysts, an efficient and minimally invasive procedure, avoids surgical intervention in the spine and its evolution is satisfactory(AU)

Solitary staphylococcal liver abcess in a neonate.

28 days old neonate presented with high fever, abdominal distension, poor feeding and lethargy. Sepsis screen was positive; ultrasound and computed tomography of the abdomen demonstrated a multiloculated hepatic abcess in the right lobe of the liver. The baby was treated with intravenous antibiotics for 6 weeks and percutaneous aspiration of the abcess, resulting in excellent recovery.

Aspiración percutánea y aplicación de ozono en quiste facetario lumbar / Percutaneous aspiration and application of ozone in lumbar facet cyst

Los quistes facetarios lumbares son anormalidades intraespinales. Causan dolor crónico de espalda y radicular moderado o severo que produce marcada limitación funcional. Se presenta el caso clínico de un paciente en el que fue posible aspirar de forma percutánea, con éxito un quiste facetario guiado por fluoroscopia y la aplicación de ozono en dicha articulación. Se concluye que la posibilidad de dar solución por métodos de mínima invasión garantiza una pronta recuperación con excelente resultado y ausencia de complicaciones.

Facet lumbar cysts are intraspinal abnormalities. Cause chronic back pain and radicular moderate or severe functional limitation resulting marked. The case of a patient in whom it was possible to aspire percutaneously, a successful facet cyst guided by fluoroscopy and application of ozone in this joint occurs. It is concluded that the possibility of providing solutions for minimally invasive methods ensures a speedy recovery with excellent results and no complications.

A clinical study on amoebic liver abscess.

Background: Amoebic liver abscess presents with severe pain and high grade fever and if not diagnosed and treated promptly, may lead to complications and mortality. Aim and objectives: The objective of the present study was to estimate the incidence, need for aspiration and prognosis. The diagnosis was based on clinical features, positive Elisa test, ultrasonography, aspiration of anchovy sauce from the liver lesion, isolation of E. Histolytica (cyst/trophozoite) from the stool of the patient. Result: We had 65 cases in the study. There were 52 males & 13 females with a ratio of 4:1. Solitary abscess was found in 48(73.8%) patients which are located as follows; right lobe(43), left lobe(2) and in both lobe(3). 9% were aspirated at presentation due to their size or position. Only 4 (2%) were aspirated at first follow-up on third day due to non resolution of pain or fever or increase in size. All the patients are responded to standard treatment of metronidazole. Amoebic liver abscess is a common diagnosis in our setup. Conclusion: Clinical background and sonogram give a reasonable suggestion about amoebic etiology. If initial aspiration is not indicated due to size larger than10 cm or proximity to surface, conservative treatment with oral or intravenous metronidazole is successful.

Percutaneous Needle Decompression during Laparoscopic Gastric Surgery: A Simple Alternative to Nasogastric Decompression

Laparoscopic gastric surgeries are routinely performed with use of a nasogastric tube to decompress the upper gastrointestinal tract. A distended upper gastrointestinal tract can complicate successful laparoscopic gastric surgery as the distention compromises not only the visual field but also the laparoscopic manipulation of the stomach. Since nasogastric intubation is not without risks, we have attempted laparoscopic-assisted gastric cancer surgeries without nasogastric tubes. In this article we describe a simple method of aspirating gastric contents using a 9 cm long 19-gauge needle inserted percutaneously during laparoscopic-assisted gastrectomy. First, a 9 cm long 19-gauge disposable needle was introduced through the abdominal wall. This needle was then introduced to the stomach through the anterior wall and the stomach gases and fluids were aspirated by connecting the needle to suction. Thus, a collapsed upper gastrointestinal tract was easily obtained. We performed this procedure instead of nasogastric decompression on twenty-two patients with gastric cancer who underwent laparoscopic-assisted distal subtotal gastrectomy with lymph node dissection. The results were good with only one patient experiencing wound infection (4.5%) and one patient with postoperative acalculus cholecystitis (4.5%). There were no patients with either intraabdominal infection or anastomotic leakage and none of the patients needed postoperative nasogastric decompression, except the patient who experienced acaculus cholecystitis. Percutaneous needle aspiration is a very simple and efficient technique with little risk of postoperative complications. It can be used as an alternative to nasogastric tube decompression of the gastrointestinal tract for laparoscopic-assisted gastrectomy.

Effect of Percutaneous Aspiration with Sclerotherapy of the Simple Renal Cyst / 대한비뇨기과학회지

PURPOSE: Recently, a percutaneous aspiration with sclerotherapy has become the treatment of choice for the symptomatic, large, and simple renal cyst because of its minimal invasiveness and high effectiveness. The recurrence rate of a percutaneous aspiration only, was reported to range from 30 to 70%. This study was performed to evaluate the effects of percutaneous aspiration with sclerotherapy. MATERIALS AND METHODS: The results of the treatment in 36 cases of simple renal cysts from October 1993 to December 1999 were evaluated. The symptoms associated with simple renal cysts were: flank pain or discomfort (50%), none (47.2%) and a palpable mass (2.8%). The simple renal cysts were treated with a percutaneous aspiration only in 6 cases, a percutaneous aspiration with sclerotherapy using 99% ethanol in 21 cases or a 10% minocycline solution in 9 cases. All patients were followed up by ultrasound for 6 to 56 months (mean 18 months). RESULTS: Complete collapse, and partial collapse rate of the renal cysts were 1/6 (16.7%), 2/6 (33.3%) in the aspiration only group, 6/21 (28.6%), 14/21 (66.7%) in the 99% ethanol group and 3/9 (33.3%), 4/9 (44.4%) in the 10% minocycline solution group, respectively. CONCLUSIONS: Therefore, a percutaneous aspiration with sclerotherapy using either 99% ethanol or 10% minocycline solution appears to be an effective way to the prevent re-accumulation of cystic fluid. However, the success rates in the percutaneous aspiration with sclerotherapy using 99% ethanol and 10% minocycline solution were not significantly different.

A Case of Renal Abscess in Healthy Child

Renal abscess is rare in children and presents varying features which often lead to delay or error in diagnosis. Fever, lumbar pain, abdominal pain and occasional flank rnass are the usual presenting cornplaints but a high degree of suspicion is important for the early detection of renal abscess. Hematogenous seeding of the kidney or ascending infection from the urinary collecting system are two proposed mechanisms of renal abscess formation. Renal ultrasonography facilitates an earlier diagnosis and is also useful in establishing percutaneous drainage, which appears to be the treatment method of choice. We experienced a case of renal abscess which was treated by percutaneous aspiration and antibiotics without surgical intervention.

Long Term Follow-up Results of Percutaneous Aspiration with Sclerotherapy of the Simple Renal Cyst / 대한비뇨기과학회지

PURPOSE: Recently the percutaneous aspiration with sclerotherapy of the simple renal cyst are being widely used because of the high success rate and the low morbidity. However, studies concerning the long term result of this technique have been rarely reported. Thus, we performed this study to evaluate the long term results of this technique. MATERIALS AND METHODS: We evaluated the long term result of the treatment in 20 cases of simple renal cysts from July 1993 to July 1998. The symptoms associated with simple renal cysts were: none(55%), pain(35%) and palpable mass(10%). The simple renal cysts were treated with percutaneous aspiration and injection of 99% ethanol in 15 cases or percutaneous aspiration and injection of 10% tetracycline solution in 5 cases. All were followed by ultrasound from 18 to 58 months(mean 32.7 months). RESULTS: Complete collapse, partial collapse and recurrence of the renal cysts were 5/15(33.3%), 7/15(46.6%), 3/15(20%) in 99% ethanol group and 3/5(60%), 1/5(20%), 1/5(20%) in 10% tetracycline solution group, respectively. Overall efficacies were 80% in both groups. Furthermore, all recurrences occurred within the first year of follow up period in both groups. CONCLUSIONS: Therefore, percutaneous aspiration with sclerotherapy using 99% ethanol or 10% tetracycline solution seem to be an effective way to prevent re-accumulation of cystic fluid. It also proved to have a positive long term result concerning the relapse of the simple renal cyst.

A Case of Percutaneous Aspiration Thromboembolectomy(PAT)

The two most common causes of acute arterial occlusion are embolism and thrombosis in sity. They are mainly originated from the cardiovascular sources. About 70-80 per cent of occlusions occur in the axial limb vessels. Therapeutic options include supportive measures, pharmacologic treatment, surgery, and non-operative interventions. There have been several successful case reports using percutaneous aspiration thromboembolectomy with the advent of new instruments and technical imprevement. We report a case of 70-year-old male with acute anterior wall myocardial infaction who experienced acute embolic arterial occlusion of the left popliteal artery from mural thrombus in the left ventricular apex. It wan managed successfully by percutaneous aspiration thromboembolectomy.

Percutaneous aspiration and sclerosing therapy on the benign renal cyst / 대한비뇨기과학회지

Percutaneous treatment of benign renal cysts has been proposed as a method of reducing the morbidity associated with surgical treatment. The results of percutaneous aspiration and sclerosing therapy of 12 benign renal cysts and 5 infected renal cysts were reviewed. Percutaneous aspiration and daily sclerosing therapy with 99% ethanol for 4-5 days were performed in 12 benign renal cysts. Sclerosing therapy with 10% tetracycline solution following aspiration was done in the remaining 5 infected renal cysts. The aspirates were analyzed for color, total lipid, protein. lactic acid dehydrogenase (LDH). amylase. glucose and smear/culture. Also, cell block was performed for detection of malignant cells. All laboratory data were transudate except 5 infected renal cysts. Cytologic and bacteriological findings were negative except 1 infected renal cyst which had positive E. coli. All were followed by ultrasound or CT from 3 to 48 months (mean follow-up 26 months). In The 17 renal cysts, 9 cysts (53%) disappeared completely and 4 cysts (24%) decreased to half the original volume within 3 months period. In the 10 cysts who had been followed for 6 months. 4 cysts (40%) were collapsed completely and 2 cysts (20%) were reduced to half rhe original volume. The cystic cavity disappeared completely in 4 of 8 cysts (50%) and was decreased to half the original volume in 2 of 8 cysts (25%) for l year period. Overall efficacy was 71%. In summary, percutaneous aspiration and sclerosing therapy using 99% ethanol or 10% tetracycline solution was effective in the treatment of benign renal cysts and infected renal cysts. Also, differential diagnosis with malignant tumor was easily made by analysis of cystic fluid. In the recurred cysts, aspiration and sclerosing therapy were performed without significant complication and morbidity, repeatedly. But long-term follow-up evaluation will be necessary to document the results of aspiration with sclerosing therapy because of the diverse natural history of the renal cyst.

Solid and Papillary Epithelial Neoplasm of the Pancreas Diagnosed by Percutaneous Fine Needle Aspiration Biopsy

Solid and papillary epithelial neoplasm of the pancreas is a rare, low grade malignant tumor of adolescence. The tumor we described was diagnosed by following preoperative percutaneous fine needle aspiration biopsy and confirmed by tissue examination. Characteristic cytologic findings were monotonous cells arranged in papillary fronds, acinus, and cords in necrotic and hemorrhagic backgrounds. Occasional foamy histiocytes and hyaline globules were present. The cytoplasm of the tumor cells were moderate in amount, pale eosinophilic or vacuolated with distinct borders. The nuclei were centrally located and round. There were one or two small nucleoli and finely granular chromatin throughout the nucleus.