Balázs A, Lukovich P, Flautner L
I. Sebészeti Klinika, Semmelweis Orvostudományi Egyetem, Budapest.
Orv Hetil. 2000 Jan 30;141(5):241-4.
Authors report the case of a 47 years old male patient with acute femoral abscess. The examinations made with urgency found proceeding acute pancreatitis, fluid collection in the right pleural cavity, exceeding fluid collections in the retroperitoneum and right paracolic region. The inflammatory infiltrate and collection in the upper third of the right thing seemed to be in connection with the proceeding pancreatitis. Because of the process endangering also the viability of the limb and severe septic state, an acute operation was performed, in the course of which extension of the retroperitoneal abscess to the thing was observed. After abdominal oncotomy expanded to thigh and inguinal region, lavage, drainage operations, therapy with wide spectrum followed by aimed antibiotics general condition of the patient improved. On the 18 postoperative day a new feverish state manifested. Image forming examinations showed newer purulent collections in the abdominal cavity and on the thigh in addition to the previous abscesses. Because of this repeated exposure was necessary. After the second operation the patient recovered without complaint and further complications. Authors think the case worth attention because of the extensive and unusual localization of abscesses formed beside the relatively discrete abdominal complaints.
作者报告了一例47岁男性急性股部脓肿患者的病例。紧急检查发现患者同时患有急性胰腺炎、右侧胸腔积液、腹膜后及右结肠旁区积液过多。右侧大腿上三分之一处的炎症浸润及积液似乎与胰腺炎进展有关。由于病情危及肢体存活且处于严重脓毒症状态,遂进行了急诊手术,术中观察到腹膜后脓肿蔓延至大腿。在将腹部切开术扩展至大腿和腹股沟区域后,进行了冲洗、引流手术,并使用广谱抗生素随后针对性使用抗生素治疗,患者的一般状况有所改善。术后第18天,患者再次出现发热症状。影像学检查显示,除先前的脓肿外,腹腔和大腿又出现了新的脓性积液。因此有必要再次手术。二次手术后,患者康复,无任何不适及进一步并发症。作者认为该病例值得关注,因为除了相对不明显的腹部症状外,脓肿形成的部位广泛且不寻常。