RESUMO
Phlegmon of retroperitoneal cellular tissue as a complication of endoscopic papillosphincterotomy (PST) was observed in 9 patients. All these patients in the first several hours after PST complained of pains in epigastrium and right hypochondrium. 2 days later the signs of pyogenous intoxication appeared. For diagnosis of complications after PST roentgenological and radionuclide methods as well as US examination and computer tomography were used. For exploration of retroperitoneal phlegmon extraperitoneal approach was employed. The phlegmon cavity was drained by number of tubes TMMK and aspiration-lavage treatment 3 patients died.
Assuntos
Celulite (Flegmão)/etiologia , Esfinterotomia Endoscópica/efeitos adversos , Infecção da Ferida Cirúrgica/etiologia , Adulto , Idoso , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/terapia , Evolução Fatal , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Espaço Retroperitoneal , Estudos Retrospectivos , Sucção , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/terapiaRESUMO
Early diagnosis of retroperitoneal festering is possible if methodologically strictly carrying out of succession of radiation methods (US, computed tomography, roentgenological examination) is applied and used in complex. Extraperitoneal approach to phlegmon of retroperitoneal cellular tissue provides good visualization and is less traumatic. Infusional and enteral therapy in postoperative period promote effective elimination of volemic disturbances, stabilization of hemodynamic indices, and provides stable curative effect.
Assuntos
Traumatismos Abdominais/cirurgia , Abscesso/terapia , Tecido Adiposo , Sistema Digestório/lesões , Espaço Retroperitoneal , Traumatismos Abdominais/complicações , Abscesso/diagnóstico por imagem , Abscesso/etiologia , Antibacterianos , Procedimentos Cirúrgicos do Sistema Digestório , Quimioterapia Combinada , Seguimentos , Humanos , Infusões Parenterais , Cuidados Pós-Operatórios , Estudos Retrospectivos , Sucção , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Based on the experience with treatment of 112 patients with retroperitoneal phlegmons of different etiology the authors distinguish and describe the diffuse and complicated forms of the disease. In treatment of phlegmons special importance is attached to the optimal surgical access. The article describes main principles of performing sanitation of the suppurative foci of the retroperitoneal space, variants of the aspiration-irrigation methods of treatment of the suppurative process. The authors believe that their original differentiated surgical method using different variants of the aspiration-irrigation drainage is effective in treatment of patients with retroperitoneal phlegmons. This method of treatment gave 23.2% lethality while after the traditional methods of treatment 90% of the patients died.
