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复发性原发性腹壁脓肿:一例报告并文献复习

Recurrent Primary Abdominal Wall Abscess: A Case Report and Review of the Literature.

作者信息

Shiihara Masahiro, Sudo Yasuhiro, Matsushita Norimasa, Osugi Harushi, Inoue Tatsuo

机构信息

Gastrointestinal Surgery, Kamifukuoka General Hospital, Saitama, JPN.

出版信息

Cureus. 2023 Jun 28;15(6):e41069. doi: 10.7759/cureus.41069. eCollection 2023 Jun.

Abstract

Primary abdominal wall abscess is extremely rare and difficult to diagnose because abdominal wall abscesses usually occur secondary to malignant tumors or inflammatory diseases. We experienced a case of an 80-year-old man with an asynchronous primary abdominal wall abscess with recurrence. Both abscesses were successfully treated with surgical drainage. A patient without any history of cancer or trauma presented to our department with right upper abdominal pain. His laboratory data showed an abnormal high inflammatory response, and computed tomography revealed a 40 × 30 mm mass formed in the rectus abdominis muscle of the upper right abdomen. The mass had no continuity with the surgical scar after cholecystectomy or intra-abdominal organs. was detected in the culture from the mass and any epithelial components were not detected by biopsy. For the diagnosis of primary abdominal wall abscess, the patient underwent surgical drainage because antibiotic treatment was ineffective. The abscess disappeared promptly after the drainage. Thirteen months after the first treatment, another primary abdominal wall abscess was noted in the lower right abdomen. The abscess also promptly disappeared with surgical drainage. Primary abdominal wall abscess is difficult to diagnose because of its rarity. Prompt diagnosis and drainage are important to prevent exacerbation.

摘要

原发性腹壁脓肿极为罕见且难以诊断,因为腹壁脓肿通常继发于恶性肿瘤或炎症性疾病。我们遇到一例80岁男性患者,患有复发性非同步原发性腹壁脓肿。两个脓肿均通过手术引流成功治愈。一名无癌症或外伤史的患者因右上腹疼痛前来我院就诊。他的实验室数据显示炎症反应异常高,计算机断层扫描显示右上腹腹直肌形成一个40×30毫米的肿块。该肿块与胆囊切除术后的手术瘢痕或腹腔内器官无连续性。从肿块培养物中检测到[具体物质未提及],活检未检测到任何上皮成分。为诊断原发性腹壁脓肿,由于抗生素治疗无效,患者接受了手术引流。引流后脓肿迅速消失。首次治疗13个月后,右下腹部又发现一个原发性腹壁脓肿。该脓肿通过手术引流也迅速消失。原发性腹壁脓肿因其罕见而难以诊断。及时诊断和引流对于防止病情加重很重要。

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