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>Journals >Cirujano General >Year 2007, Issue 1


Quezada-Adame I, Medina-Villaseñor EA, Fernández-Garza MC, Cabrera-Albarrán A, Balice-Olguín O, Avilés-Tlalpan MP
Amebic peritonitis due to hepatic abscese rupture
Cir Gen 2007; 29 (1)

Language: Español
References: 34
Page: 17-21
PDF: 4. Kb.


Full text




ABSTRACT

Objective: To describe the surgical experience in cases of peritonitis due to rupture of an amebic liver abscess.
Setting: General Hospital of Atizapán, “Dr Salvador González Herrerón”, ISEM.
Design: Retrospective, transversal, descriptive study.
Statistical analysis: Percentages as summary measure for qualitative variables.
Material and methods: We reviewed the clinical records of patients subjected to surgery due to an amebic liver abscess in a 10-year period. Analyzed variables were: age, gender, indication for surgery, location of the abscess, extension, type of used treatment, morbidity and mortality.
Results: Of 76 patients with amebic liver abscess, 28 (35%) required surgical drainage due to imminent rupture or lack of response to medical treatment; eight (10%) presented free interperitoneal rupture and diffuse secondary peritonitis; one patient (1.2%) presented rupture that extended to the pleura. Rupture predominated in men with an average age of 38 years; the most common location of the abscess was in the right lobe; peritonitis was the most frequent indication for surgery. In all surgical cases, the abscess was aspired, the cavity irrigated, drainage was applied, and treatment consisted of metronidazole and third generation cephalosporin, or dehydroemetine. One patient (1.2%) died due to extension to the pleura and empyema.
Conclusions: Laparotomy must be performed in patients with abscess rupture. The general treatment principles applied to intraabdominal infections must be used with the administration of metronidazole and third generation cephalosporin.


Key words: Amebic liver abscess, amebic peritonitis, surgical treatment.


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