1.Infections of the deep neck spaces.
Amogh HEDGE ; Suyash MOHAN ; Winston Eng Hoe LIM
Singapore medical journal 2012;53(5):305-quiz 312
Deep neck infections (DNI) have a propensity to spread rapidly along the interconnected deep neck spaces and compromise the airway, cervical vessels and spinal canal. The value of imaging lies in delineating the anatomical extent of the disease process, identifying the source of infection and detecting complications. Its role in the identification and drainage of abscesses is well known. This paper pictorially illustrates infections of important deep neck spaces. The merits and drawbacks of imaging modalities used for assessment of DNI, the relevant anatomy and the possible sources of infection of each deep neck space are discussed. Certain imaging features that alter the management of DNI have been highlighted.
Abscess
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complications
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diagnosis
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surgery
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Diagnosis, Differential
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Drainage
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Humans
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Magnetic Resonance Imaging
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Neck
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Neck Pain
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diagnosis
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etiology
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Soft Tissue Infections
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complications
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diagnosis
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surgery
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Tomography, X-Ray Computed
2.Multiple Pyogenic Liver Abscesses Caused by Microperforation of an Idiopathic Cecal Ulcer.
Dong Han YEOM ; Ki Chang SOHN ; Min Su CHU ; Dong Ho JO ; Eun Young CHO ; Haak Cheoul KIM
The Korean Journal of Gastroenterology 2016;67(1):44-48
Idiopathic cecal ulcer is a rare disease entity of unknown cause diagnosed by ruling out other known causes of cecal ulceration. The most common complication of an idiopathic cecal ulcer is bleeding; perforation, peritonitis, abscess, and stricture formation have been noted. The authors treated a 53-year-old woman who presented with fever and intermittent right upper quadrant abdominal pain. Multiple pyogenic liver abscess and a solitary cecal ulcer were diagnosed by radiologic, endoscopic, and pathologic examination, followed by laparoscopic cecectomy. After extensive study, we concluded that this patient's liver abscesses were a complication of the idiopathic cecal ulcer. Herein, we report a case of multiple pyogenic liver abscess caused by microperforation of idiopathic cecal ulcer.
Cecal Diseases/complications/*diagnosis/surgery
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Colonoscopy
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Female
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Humans
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Laparoscopy
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Liver/pathology
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Liver Abscess, Pyogenic/*diagnosis/etiology
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Middle Aged
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Tomography, X-Ray Computed
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Ulcer/complications/*diagnosis/surgery
3.Vesicocutaneous Fistula Presenting Groin Abscess and Chronic Osteomyelitis in Pubic Bone.
Sang Bum KIM ; Woong Kyo JUNG ; Dong Ik SONG ; Soon Hyuck LEE
Clinics in Orthopedic Surgery 2009;1(3):176-179
The authors report a case of bladder fistula associated with a medial thigh cutaneous fistula and chronic osteomyelitis of the pubic bone 11 years after surgery for a pelvic bone fracture and bladder rupture. In the presenting case, despite the clinical suspicion, none of the diagnostic tools demonstrated the bladder fistula preoperatively. This case suggests that bladder repair should be prepared, even if the bladder fistula cannot be confirmed by imaging studies because the amount of urine leakage can be minimal or the fistula can close spontaneously.
Abscess/complications/*diagnosis
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Cutaneous Fistula/complications/*diagnosis/radiography/surgery
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Groin
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Humans
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Male
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Middle Aged
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Osteomyelitis/complications/*diagnosis/radiography
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Pelvis/radiography
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*Pubic Bone/surgery
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Urinary Bladder Fistula/complications/*diagnosis/radiography/surgery
4.Psoas Abscess with Hip Contracture in a Patient with Crohn's Disease.
Hye Jeong PARK ; Yong Cheol JEON ; Kyeonga LEE ; Tae Jun BYUN ; Tae Yeob KIM ; Chang Soo EUN ; Dong Soo HAN ; Joo Hyun SOHN
The Korean Journal of Gastroenterology 2008;52(3):188-191
A psoas abscess (PA) is a rare clinical entity but is potentially serious condition which presents diagnostic and therapeutic challenges. The diagnosis is frequently delayed due to its variable and nonspecific features and occult clinical course. The delay in diagnosis and treatment of PA is the major poor prognostic factor. We describe herein a case of the sterile psoas abscess complicating Cronh's disease which presented as hip flexion contracture. A 29-year-old man, at remission stage of CD involving ileocolic segment, was admitted due to pain from hip contracture. He had no bloody diarrhea and no abdominal pain. PA was confirmed by abdominal ultrasound. PA with hip contracture was completely treated with surgical excision, irrigation, drainage, and antibiotics. PA was sterile and there was no evidence of a fistulous communication from the bowel. Once suspected, aggressive diagnostic work up and definitive operative intervention is needed.
Adult
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Crohn Disease/*complications/drug therapy
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Diagnosis, Differential
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Drainage
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Hip Contracture/complications/*diagnosis/surgery
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Humans
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Male
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Psoas Abscess/*diagnosis/etiology/ultrasonography
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Tomography, X-Ray Computed
5.Clinical analysis of esophageal perforation and neck abscess induced by esophageal foreign body.
Qingjia GU ; Jiangang FAN ; Jingxian LI ; Gang HE
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(7):459-461
OBJECTIVE:
To investigate the diagnosis and treatment of esophageal perforation and neck abscess induced by esophageal foreign body and to make a better solution for the disease.
METHOD:
Twenty-four cases with esophageal perforation and neck abscess induced by esophageal foreign body treated in our department were surgery under general anesthesia. The foreign bodies were removed via esophagoscope in 14 cases, thorocomy in 3 eral neck incision in 5; and no foreign bodies were found in 2 cases.
RESULT:
There were 16 cases complicated by abscess. Among these complications,there were 10 cases of periesophageal abscess,4 cases of neck abscess and 1 case of mediastinal abscess. In 24 patients, 21 cases cured and one died. One case was sent to the department of endocrinology because of hyperglycaemia and two cases were sent to the department of thoracic surgery for further treatment.
CONCLUSION
Early diagnosis and treatment is the key to the management of esophageal perforation induced by esophageal foreign body. Thin-section CT has a high value for the diagnosis and differential diagnosis in such patients. Once deep neck abscess is diagnosed, an early abscess surgical drainage, an appropriate antibiotics and a nutrition supporting treatment are effective for the patients.
Abscess
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etiology
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surgery
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Adolescent
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Adult
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Aged
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Diagnosis, Differential
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Drainage
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Esophageal Perforation
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etiology
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surgery
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Esophagus
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Female
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Foreign Bodies
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complications
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surgery
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Humans
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Male
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Middle Aged
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Neck
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pathology
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Young Adult
6.Sequential Magnetic Resonance Imaging Finding of Intramedullary Spinal Cord Abscess including Diffusion Weighted Image: a Case Report.
Jae Eun ROH ; Seung Young LEE ; Sang Hoon CHA ; Bum Sang CHO ; Min Hee JEON ; Min Ho KANG
Korean Journal of Radiology 2011;12(2):241-246
Intramedullary spinal cord abscess (ISCA) is a rare infection of the central nervous system. We describe the magnetic resonance imaging (MRI) findings, including the diffusion-weighted imaging (DWI) findings, of ISCA in a 78-year-old man. The initial conventional MRI of the thoracic spine demonstrated a subtle enhancing nodule accompanied by significant edema. On the follow-up MRI after seven days, the nodule appeared as a ring-enhancing nodule. The non-enhancing central portion of the nodule appeared hyperintense on DWI with a decreased apparent diffusion coefficient (ADC) value on the ADC map. We performed myelotomy and surgical drainage, and thick, yellowish pus was drained.
Abscess/complications/*diagnosis/surgery
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Aged
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Anti-Bacterial Agents/therapeutic use
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Diagnosis, Differential
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Diffusion Magnetic Resonance Imaging
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Drainage
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Humans
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Magnetic Resonance Imaging/*methods
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Male
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Paraplegia/etiology
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Spinal Cord Diseases/complications/*diagnosis/surgery
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Thoracic Vertebrae
7.A Case of Subcapsular Liver Abscess Secondary to Perforating Ulcer of Gastric Cancer.
Do Hyeong KIM ; Chang Hun LEE ; Hyun Gwang JUNG
The Korean Journal of Gastroenterology 2010;56(2):109-112
Intrahepatic abscess is an unusual complication of peptic ulcer disease. We present a case of gastric cancer in which the ulcer penetrated into the left lobe of liver with subsequent abscess and fistula formation. Esophagogastroduodenoscopy confirmed ulcers and a fistula opening in the antrum. Abdominal computed tomogram showed a subcapsular liver abscess adjacent to the gastric antrum. Subtotal gastrectomy with curettage of the fistulous tract was performed. The final diagnosis was the signet ring cell gastric carcinoma complicating subcapsular liver abscess. To our knowledge, this is the first reported case in Korea.
Endoscopy, Gastrointestinal
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Female
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Humans
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Klebsiella pneumoniae/isolation & purification
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Liver Abscess/diagnosis/*etiology/microbiology
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Middle Aged
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Peptic Ulcer Perforation/*complications/diagnosis
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Stomach Neoplasms/complications/*diagnosis/surgery
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Tomography, X-Ray Computed
8.Eikenella Corrodens Cervical Spinal Epidural Abscess Induced by a Fish Bone.
Seong Ho JEON ; Dong Chul HAN ; Sang Gu LEE ; Hyeon Mi PARK ; Dong Jin SHIN ; Yeong Bae LEE
Journal of Korean Medical Science 2007;22(2):380-382
Cervical spinal epidural abscess, caused by fish bone injury and a secondary infection by Eikenella corrodens which is part of the normal flora, has not been reported. A 72-yr-old man came to the hospital with pain in his posterior neck and both shoulders for 2 months. He also was experiencing weakness on his right side for 3 days. A fish bone had been stuck in his throat for about 2 months. Neurological examination revealed right hemiparesis, hypesthesia on the left extremities and neck stiffness. Laboratory findings showed an elevated ESR/CRP and leukocytosis, and magnetic resonance imaging revealed a retropharyngeal abscess and cervical myelitis. The patient was treated with emergency surgical decompression and antibiotics. A fish bone was removed from the C3-C4 intervertebral disc space. In the culture of chocolate blood agar and 5% sheep blood agar plate, E. corrodens was detected as a causative organism.
Male
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Humans
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Gram-Negative Bacterial Infections/diagnosis/*etiology/prevention & control
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Foreign Bodies/*complications/*surgery
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Food/*adverse effects
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Fishes
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Epidural Abscess/diagnosis/*etiology/*surgery
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Eikenella corrodens/*isolation & purification
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Decompression, Surgical
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Bone and Bones
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Anti-Bacterial Agents/administration & dosage
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Animals
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Aged
9.Liver Abscess and Empyema due to Lactococcus lactis cremoris.
Hye Sook KIM ; Dae Won PARK ; Young Kyoung YOUN ; Yu Mi JO ; Jeong Yeon KIM ; Joon Young SONG ; Jang Wook SOHN ; Hee Jin CHEONG ; Woo Joo KIM ; Min Ja KIM ; Won Suk CHOI
Journal of Korean Medical Science 2010;25(11):1669-1671
Lactococcus lactis cremoris infections are very rare in humans. We experienced liver abscess and empyema due to L. lactis cremoris in an immunocompetent adult. A 42-yr-old man was admitted with fever and abdominal pain. Abdominal computed tomography (CT) revealed a liver abscess and chest CT showed loculated pleural effusion consistent with empyema. L. lactis cremoris was isolated from culture of the abscess material and blood. The patient was treated with pus drainage from liver abscess, video-assisted thoracoscopic decortications for empyema, and antibiotics including cefotaxime and levofloxacin. The patient was completely recovered with the treatment. To our knowledge, this is the first report of a L. lactis cremoris infection in Korea.
Adult
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Anti-Bacterial Agents/therapeutic use
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Cefotaxime/therapeutic use
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Drainage
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Empyema/*diagnosis/*microbiology/surgery
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Gram-Positive Bacterial Infections/complications/*diagnosis/drug therapy
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Humans
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*Lactococcus lactis/drug effects/isolation & purification
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Liver Abscess/*diagnosis/*microbiology
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Male
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Microbial Sensitivity Tests
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Ofloxacin/therapeutic use
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Thoracic Surgery, Video-Assisted
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Tomography, X-Ray Computed