Nabri Mamoun, Alharbi Mohammed, Al-Sayyid Amnah, Alabdrabalrasol Kawthar, Hassan Khairi, Al-Jehani Hussam
Department of Surgery, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Department of Surgery, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Int J Surg Case Rep. 2020;76:30-32. doi: 10.1016/j.ijscr.2020.09.063. Epub 2020 Sep 24.
Subgaleal abscess is a rare condition in which suppuration under the galea aponeurotica (epicranial aponeurosis) occurs. Diagnosis of subgaleal abscess is guided by high index of suspicion, imaging of the head by computed topography will confirm the diagnosis and detect osteomyelitis or intracranial extension.
We describe a case of extensive subgaleal abscess that presented as an infected scalp sebaceous cyst, in male diabetic patient, its management and the role of vaccum assisted closure (V.A.C.) dressing which was never described in such atypical presentation.
The subgaleal space is the between the galea aponeurotica and periosteum of the cranial bones, subgaleal abscess may result from hematogenous infection or contiguous spread, and the diagnosis may not be initially obvious The predominant organism isolated from post-traumatic and post-surgical scalp infections is Staphylococcus aureus (Haines and Chou, 1985). Diagnosis and management will be guided by head CT scan, management of subgaleal abscess should focus on effective intravenous antibiotic therapy, immediate surgical drainage of abscess and debridement of necrotic tissue.
Subgaleal abscess is a rare complication, imaging can prevent serious complications. Negative pressure wound therapy is an invaluable tool for closure of the wounds.
帽状腱膜下脓肿是一种罕见病症，指帽状腱膜（颅顶腱膜）下发生化脓。帽状腱膜下脓肿的诊断需高度怀疑，头部计算机断层扫描成像可确诊并检测出骨髓炎或颅内蔓延情况。
我们描述了一例广泛的帽状腱膜下脓肿病例，该病例表现为一名男性糖尿病患者的头皮皮脂腺囊肿感染，介绍了其治疗方法以及负压封闭引流（V.A.C.）敷料在此非典型病例中的作用，此前从未有过此类描述。
帽状腱膜下间隙位于帽状腱膜与颅骨骨膜之间，帽状腱膜下脓肿可能由血源性感染或邻近扩散引起，最初诊断可能并不明显。从创伤后和手术后头皮感染中分离出的主要病原体是金黄色葡萄球菌（海恩斯和周，1985年）。诊断和治疗将以头部CT扫描为指导，帽状腱膜下脓肿的治疗应侧重于有效的静脉抗生素治疗、脓肿的立即手术引流以及坏死组织的清创。
帽状腱膜下脓肿是一种罕见的并发症，影像学检查可预防严重并发症。负压伤口治疗是伤口闭合的宝贵工具。
