UNLABELLED: Skin and Soft Tissue Infections (SSTIs) encompass a wide spectrum of inflammatory diseases of the skin, subcutis, fascia and muscles. Recent national trends indicate increasing rates of patients treated for these diagnoses at outpatient surgical department, but also of patients hospitalized with severe forms of SSTIs. Up to 90% fatality rates are reported in the literature for the most severe forms, resulting from underestimation of initial symptoms and therefore delayed onset of radical therapy only the phase of septic shock. The paper provides an interdisciplinary review of essential principles of the diagnosis and therapy of SSTIs, reflecting present knowledge supported by evidence-based medicine. KEY WORDS: skin and soft tissue infections - SSTIs - necrotizing fasciitis - diagnosis - therapy.
- MeSH
- časná diagnóza MeSH
- časná lékařská intervence MeSH
- infekce měkkých tkání komplikace diagnóza terapie MeSH
- infekční nemoci kůže komplikace diagnóza terapie MeSH
- lidé MeSH
- medicína založená na důkazech * MeSH
- progrese nemoci MeSH
- septický šok etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Our report presents the case of a young woman who suffered liver trauma after electrical current injury and ensuing fall from an electricity pylon. The resulting intrahepatic hematoma manifested after a time interval of 48 hours following the injury, with initially negative CT scan.Key words: liver hematoma electrical current - polytrauma burns.
- MeSH
- dospělí MeSH
- hematom diagnóza etiologie MeSH
- játra zranění MeSH
- lidé MeSH
- nemoci jater diagnóza etiologie MeSH
- počítačová rentgenová tomografie MeSH
- polytrauma * MeSH
- poranění břicha komplikace diagnóza MeSH
- zpomalení škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Secondary peritonitis is the most common cause of inflammatory acute abdomen treated at general surgery departments. Only early and correct diagnosis may improve the prognosis of these patients. The authors compiled an interdisciplinary review of the basic principles of diagnosis and treatment of secondary peritonitis, which reflects current findings supported by evidence-based medicine. The work is based on published international literature but also shares opinions and experiences of the selected specialists. The presented work in its extent is not meant to substitute an in-depth study of the issue, but to allow a basic and quick review of the topic.
- MeSH
- antiinfekční látky terapeutické užití MeSH
- chirurgie trávicího traktu MeSH
- diagnostické zobrazování MeSH
- lidé MeSH
- peritonitida diagnóza etiologie terapie MeSH
- prognóza MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- antiinfekční látky MeSH
BACKGROUND: Arosion of peripancreatic arteries in acute or chronic pancreatitis is a rare cause of bleeding into gastrointestinal tract--hemosuccus pancreaticus. Aim of the paper is to show the diagnostic and therapeutic options in this serious clinical stage. METHODS AND RESULTS: We report a case of a patient with chronic pancreatitis who developed acute bleeding into the gastrointestinal tract due to the perforation of a pseudoaneurysm into pancreatic pseudocyst in the area of the pancreatic body. The diagnosis of hemosuccus pancreaticus, established by endoscopy and postcontrast CT examination, was confirmed by angiography. We stopped the acute bleeding from pseudoaneurysm, unusually well supplied by both gastric arteries by embolization of both arteries with metallic coils. CONCLUSIONS: Angiography plays an irreplaceable role in patients with hemosuccus pancreaticus. Our case demonstrates bleeding from pseudoaneurysm supplied by both gastric arteries, whose embolization produced an immediate hemostasis and improvment the patient's condition.
- MeSH
- arterie MeSH
- chronická pankreatitida komplikace MeSH
- dospělí MeSH
- gastrointestinální krvácení etiologie terapie MeSH
- lidé MeSH
- nepravé aneurysma komplikace diagnostické zobrazování MeSH
- pankreatická pseudocysta komplikace MeSH
- prasklé aneurysma komplikace diagnostické zobrazování MeSH
- radiografie MeSH
- terapeutická embolizace * MeSH
- žaludek krevní zásobení MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Cutting wounds and bruises in the area of neck are very specific. The overall rehabilitation of these conditions is difficult and often needs to be combined with special and customised orofacial prostheses. This case-study reports special multidisciplinary treatment. The surgical diagnosis was: a cutting wound on a neck caused by a chain saw and disruption of oropharynx. Due to contusion of the tongue root and contusion of both hypoglossal nerves, a complete paralysis of tongue occurred. The tongue was immobile and the patient has problems with swallowing fluids. A special palatal prosthesis was made to reduce the space between the tongue and the palate. The fluoroscopically monitored swallowing action helps to receive optimal patient's rehabilitation.
Both stercoral peritonitis and pyothorax are rare but until nowadays threatening conditions. The presence of stool in the pleural cavity represents a curiosity, the gangrene and loss of the diaphragma is eminently rare. All above mentioned conditions occurred at the same time in the patient operated on for diffuse peritonitis after diverticular perforation of sigmoid. Surgery rescued peritoneal and pleural cavity. The absent diaphragma was replaced by mesh prosthesis, due to late intraabdominal complications the mesh was explantated. The patient survived and healed after repeated surgeries and long-lasting highly intensive therapy. Thanks to dislocation of viscera and adhaesive obliteration of the site of missing diaphragma left lung remained inflated and functional. The complication after 1 year--gastrobronchial fistula--was healed by left-sided pneumonectomy and suturing of the stomach.
- MeSH
- bránice patologie MeSH
- divertikulitida tlustého střeva komplikace MeSH
- gangréna MeSH
- lidé středního věku MeSH
- lidé MeSH
- nekróza MeSH
- perforace střeva komplikace MeSH
- peritonitida komplikace MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
During the period from January 2000 to November 2001 the authors performed in 98 patients 129 drainages of pathological fluid collections. In all instances the drainages were performed under CT control. In 80 patients the drain was placed in the area of the pleural cavity, in 47 in the area of the peritoneal cavity and in three patients the localization was different. For drainage they used catheters of the pigtail type size from 8F to 24 F, depending on the extent of the pathological collection, its depth, and nature of the drained contents. In 119 cases Seldinger's method was used, in 10 the tandem troacar method of placement of drainage catheters. The placement of the drainage catheter under CT control is a safe and effective method for removal of pathological fluid collection. In the authors' group successful drainage was proved in 71 of 84 (84.5%) patients followed up on a long-term basis.
- MeSH
- ascites terapie MeSH
- dospělí MeSH
- drenáž metody MeSH
- intervenční radiografie * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- pleurální výpotek terapie MeSH
- počítačová rentgenová tomografie * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
Southern Moravia is one of the areas where there are long-term natural foci of tularaemia. In 1994 in the Breclav district an exacerbation of the disease was recorded in hares. During autumn hunts a positive reaction was recorded in 5.75% of examined hares. An elevated seropositivity persisted also in subsequent years and at the same time a higher human morbidity in the mentioned region. The objective of the investigation was to assess the causes and circumstances which led to the exacerbation of old known but in recent years quiescent foci in the mentioned region. To this end 350 small terrestrial mammals were examined. In one case it proved possible to detect the causal agent in Microtus arvalis. By examination of arthropods it proved possible to isolate 33 strains, i.e. 32 strains from ticks Dermacentor reticulatus and one strain from Ixodes ricinus. The results of the examination revealed that tularaemia as a classical infection with a natural focus may persist in areas where there are prerequisites for survival of the causal agent in the environment. One of the important factors of the environment are susceptible individuals (hares, small terrestrial mammals) as well as blood sucking arthropods as vectors of the disease.
- MeSH
- Francisella tularensis izolace a purifikace MeSH
- hlodavci mikrobiologie MeSH
- incidence MeSH
- klíšťata mikrobiologie MeSH
- Lagomorpha mikrobiologie MeSH
- lidé MeSH
- tularemie epidemiologie veterinární MeSH
- zdroje nemoci * MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
BACKGROUND: Although many reports describe the use of diagnostic endoscopic retrograde cholangiopancreatography (ERCP) in children, few mention therapeutic application of this technique in pediatric patients with pancreatic or biliary disease. METHODS: We report our 4-year experience of 80 ERCPs performed in 59 children for obstructive jaundice or cholestasis with dilatation of the biliary tree (32 children), biliary atresia (11), recurrent pancreatitis (8), and blunt trauma to the abdomen (8). RESULTS: The patients' ages ranged from 5 weeks to 18 years. The appropriate duct was cannulated in 94% of cases. Common bile duct sphincterotomy was performed in 35 patients and pancreatic duct sphincterotomy in one. Multiple procedures were done in 16 patients where biliary stents were inserted; in one patient with chronic pancreatitis and pancreaticolithiasis, pancreatic stent was inserted. Four patients developed mild pancreatitis, one had moderate pancreatitis and one had leak of contrast, which was treated by administration of clear fluids orally for one day. One patient with benign stenosis of the hepatic duct developed cholangitis after migration of the stent into the bowel lumen. CONCLUSION: Diagnostic and therapeutic ERCP can be done as safely and effectively in pediatric patients as in adults.
- MeSH
- cholangiopankreatografie endoskopická retrográdní metody statistika a číselné údaje MeSH
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- nemoci slinivky břišní diagnóza chirurgie MeSH
- nemoci žlučového ústrojí diagnóza chirurgie MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- senzitivita a specificita MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- Geografické názvy
- Indie MeSH
A total of 924 questing Dermacentor reticulatus (Fabricius), 504 Ixodes ricinus (L.), sixty Haemaphysalis concinna Koch and 718 mosquitoes (Aedes spp.) were examined in a floodplain forest ecosystem during the 1994-95 outbreak of tularaemia in South Moravia, Czech Republic. Francisella tularensis was not isolated from H.concinna ticks or Aedes spp. mosquitoes, whereas twenty-one isolates were recovered from the other haematophagous arthropods. Dermacentor reticulatus revealed a significantly higher infection rate (2.6%) than I.ricinus (0.2%). This tick species acts as principal vector for tularaemia in the enzootic focus. Monitoring of D.reticulatus for F.tularensis thus seems to be a very efficient approach in the surveillance of tularaemia in the flood-plain forest ecosystems of Europe.
- MeSH
- Aedes mikrobiologie MeSH
- členovci - vektory mikrobiologie MeSH
- Dermacentor mikrobiologie MeSH
- ekosystém MeSH
- Francisella izolace a purifikace MeSH
- klíšťata mikrobiologie MeSH
- klíště mikrobiologie MeSH
- králíci mikrobiologie MeSH
- lidé MeSH
- tularemie epidemiologie mikrobiologie MeSH
- zvířata MeSH
- Check Tag
- králíci mikrobiologie MeSH
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
