RESUMO
Bleeding pseudoaneurysm of a peripancreatic artery is a rare cause of gastrointestinal haemorrhage. Arterial pseudoaneurysm develops as a result of partial enzymatic damage of arterial wall in acute or chronic pancreatitis. The authors report the case of a 60-years old man with bleeding into the lienal flexure of the colon due to the erosion of the pseudoaneurysm of a branch of splenic artery into the pancreatic pseudocyst in the tail region of the pancreas communicating with the colon. The diagnosis was established by CT-scan and angiography. The patient underwent surgery with the ligation of the bleeding vessel and the resection of the part of the colon.
Assuntos
Falso Aneurisma/complicações , Doenças do Colo/etiologia , Hemorragia Gastrointestinal/etiologia , Pseudocisto Pancreático/complicações , Artéria Esplênica , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Doenças do Colo/cirurgia , Hemorragia Gastrointestinal/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pseudocisto Pancreático/diagnóstico por imagem , Pseudocisto Pancreático/cirurgia , Radiografia , Artéria Esplênica/diagnóstico por imagemRESUMO
Craniocerebral trauma is one of major risk factors for development of meningitis. We reviewed 30 cases of bacterial meningitis occurring in community after craniocerebral trauma. Alcohol abuse was significant risk factor occurring in trauma patients with meningitis present in 50% in our cohort (p=0.0001). The most common pathogen in posttraumatic meningitis was Str. pneumoniae (90% vs. 33.8%, p=0.0001). However mortality was very low, only 5% probably because of early diagnosis and treatment of patients at risk for bacterial meningitis but neurologic sequellea were significantly more common (p=0.00001) in patients after craniocerebral trauma.
Assuntos
Transtornos Relacionados ao Uso de Álcool/complicações , Traumatismos Craniocerebrais/complicações , Meningites Bacterianas/etiologia , Antibacterianos/uso terapêutico , Bactérias/classificação , Bactérias/patogenicidade , Dano Encefálico Crônico/etiologia , Dano Encefálico Crônico/prevenção & controle , Estudos de Coortes , Infecções Comunitárias Adquiridas/etiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/mortalidade , Infecções Comunitárias Adquiridas/terapia , Humanos , Meningites Bacterianas/microbiologia , Meningites Bacterianas/mortalidade , Meningites Bacterianas/terapia , Avaliação de Resultados em Cuidados de Saúde , Fatores de RiscoRESUMO
Meningitis associated with bacteremia is rare. Bacteremic form of meningitis occurred in 28 of 201 cases of community acquired meningitis (14%) in Slovakia within last 17 years. Bacteremic meningitis was associated with diabetes (21.4% vs. 7.5%, p=0.02) and with higher treatment failures (32.1% vs. 9.5%, p=0.01) and higher mortality (25% vs. 12.4%, NS). In univariate analysis comparing 28 cases of bacteremic community acquired bacterial meningitis (BCBM) to all CBM, no significant risk factor concerning underlying disease (cancer, ENT infection, alcohol abuses, trauma, splenectomy, etc.) or etiology was observed apart of diabetes mellitus, which was more common among bacteremic meningitis (21.4% vs. 7.5%, p=0.02). Mortality (25% vs. 12.4%, NS) insignificantly but therapy failure (32.1% vs. 9.5%, p=0.01) was significantly more frequently observed among meningitis with bacteremia. N. meningitis was the commonest causative agent (8 of 28 cases) followed by Str. pneumoniae (6), gram-negative bacteria (6), S. aureus (4) and H. influenzae (2).
Assuntos
Bacteriemia/complicações , Complicações do Diabetes/microbiologia , Meningites Bacterianas/complicações , Bacteriemia/terapia , Bactérias/isolamento & purificação , Infecções Comunitárias Adquiridas/complicações , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/terapia , Complicações do Diabetes/terapia , Diabetes Mellitus/microbiologia , Humanos , Meningites Bacterianas/microbiologia , Meningites Bacterianas/terapia , Avaliação de Resultados em Cuidados de Saúde , Fatores de Risco , Falha de TratamentoRESUMO
Meningitis after artificial implants in 60 children, mainly after foreign body infections (FBI) was caused more frequently by coagulase negative staphylococci and Ps. aeruginosa than other organisms and was significantly associated with perinatal trauma, hydrocephalus, haemorrhage or VLBW and had more neurologic sequels despite mortality was similar to other nosocomial meningitis.
Assuntos
Derivações do Líquido Cefalorraquidiano/efeitos adversos , Meningite/complicações , Infecções Relacionadas à Prótese/complicações , Infecções por Pseudomonas/complicações , Infecções Estafilocócicas/complicações , Lesões Encefálicas/complicações , Lesões Encefálicas/microbiologia , Lesões Encefálicas/cirurgia , Criança , Pré-Escolar , Corpos Estranhos/microbiologia , Humanos , Hidrocefalia/complicações , Hidrocefalia/cirurgia , Lactente , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Hemorragias Intracranianas/complicações , Meningite/microbiologia , Procedimentos Neurocirúrgicos/efeitos adversos , Infecções Relacionadas à Prótese/microbiologiaRESUMO
Two hundred-sixty-one (261) cases of cerebral malaria within last 8 years from 3 tropical clinics in South Sudan were analyzed. Coma was present at 79.8% and convulsions at 25.6%. However 90.5% of children were cured. Commonest antimalarial drugs used were intravenous quinine, clindamycin, artesunate and artemeter.
Assuntos
Antimaláricos/uso terapêutico , Coma/epidemiologia , Malária Cerebral/epidemiologia , Artemeter , Artemisininas/uso terapêutico , Pré-Escolar , Clindamicina/uso terapêutico , Comorbidade , Quimioterapia Combinada , Febre/epidemiologia , Humanos , Lactente , Malária Cerebral/tratamento farmacológico , Malária Cerebral/mortalidade , Quinina/uso terapêutico , Estudos Retrospectivos , Convulsões/epidemiologia , Sudão/epidemiologiaRESUMO
The author presents a patient with an congenital malformation, megacolon congenitum, with total agangliosis of the large bowel. Total colectomy was performed preserving part of the rectum with subsequent Duhamel's operation. After four years, at the age of 5.5 years the postoperative course was complicated by an inflammation of the rectum with the subsequent development of multiple fistulae in the perianal, perineal, gluteal and labial area. The condition had a rapid septic course. The patient was subjected to repeated ileostomy. Under general antibiotic treatment and Sulfasalazine the patient's condition improved.