Objective:To explore the clinical characteristics and treatment methods of middle ear cholesteatoma with intracranial and extracranial complications as the first diagnosis. Methods:A total of 244 patients were initially diagnosed with intracranial and/or extracranial complications associated with middle ear cholesteatoma at the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2022, and medical records were collected and retrospectively analyzed. Results:Among 244 patients with intracranial and extracranial complications of middle ear cholesteatoma, 203 cases had one complication, 34 cases had 2 complications, and 7 cases had 3 or more complications. One hundred and eighty-six cases presented labyrinthitis, 41 cases had peripheral facial paralysis, 27 cases had periauricular abscess, 12 cases had meningitis, 10 cases had brain abscess, 7 cases had sigmoid sinus lesions, 6 cases had epidural abscess, and 4 cases demonstrated hydrocephalus. Conclusion:The destructive nature of middle ear cholesteatoma can lead to intracranial and extracranial complications. The incidence rate of extracranial complications is highest for labyrinthitis. Patients with otitis media who complained dizziness should raise clinical suspicion for potential labyrinthitis. The second most prevalent extracranial complication is peripheral facial paralysis, and early facial nerve decompression surgery is critical for better recovery of facial paralysis symptoms. Brain abscess is the most common intracranial complications, which has the highest fatality rate. Clinicians should be alert to otogenic brain abscess. Otolaryngology and neurosurgery teams should cooperate and evaluate patients' middle ear lesions and brain abscess, and jointly develop personalized treatment plans.
Humans ; Cholesteatoma, Middle Ear/surgery* ; Retrospective Studies ; Facial Paralysis/etiology* ; Brain Abscess/diagnosis* ; Male ; Female ; Otitis Media/complications* ; Meningitis/etiology* ; Labyrinthitis/etiology* ; Adult ; Middle Aged ; Young Adult

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 ; Colonoscopy ; Female ; Humans ; Laparoscopy ; Liver/pathology ; Liver Abscess, Pyogenic/*diagnosis/etiology ; Middle Aged ; Tomography, X-Ray Computed ; Ulcer/complications/*diagnosis/surgery

Endoscopic tattooing with India ink is generally regarded as a safe procedure that enables ready identification of endoluminal cancer from the serosal surface. However, significant complications have been reported, including local inflammatory pseudotumor formation, peritonitis, rectus muscle abscess, small bowel infarction, and phlegmonous gastritis. Although the mechanism of complication is not completely understood, it may be related to the chemical compounds contained in the ink solution and enteric or extraenteric bacterial inoculation by injection needle or the ink itself. Authors encountered a case of a 60-year-old man with a resectable sigmoid colon cancer which was tattooed with India ink for subsequent localization in the intraoperative setting. During the laparoscopic operation, the proximal and distal margin of the lesion appeared edematous with bluish color. The distal resection margin was extended approximately 5 cm more than expected because of long extent of edematous mucosa. Histologic examination of the edematous tattooing area revealed an ink abscess spreading laterally above the muscularis propria. Although tattooing is widely used and relatively safe, the presented case indicates the risk of infection or inflammation by tattooing.
Abscess/*diagnosis/etiology/pathology ; Carbon/*adverse effects ; Colonoscopy ; Humans ; Intestinal Mucosa/pathology/surgery ; Laparoscopy ; Male ; Middle Aged ; Sigmoid Neoplasms/surgery ; *Tattooing

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 ; etiology ; surgery ; Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Drainage ; Esophageal Perforation ; etiology ; surgery ; Esophagus ; Female ; Foreign Bodies ; complications ; surgery ; Humans ; Male ; Middle Aged ; Neck ; pathology ; Young Adult

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 ; complications ; diagnosis ; surgery ; Diagnosis, Differential ; Drainage ; Humans ; Magnetic Resonance Imaging ; Neck ; Neck Pain ; diagnosis ; etiology ; Soft Tissue Infections ; complications ; diagnosis ; surgery ; Tomography, X-Ray Computed

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 ; Aged ; Anti-Bacterial Agents/therapeutic use ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging ; Drainage ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Paraplegia/etiology ; Spinal Cord Diseases/complications/*diagnosis/surgery ; Thoracic Vertebrae

Hepatocellular carcinoma (HCC) is one of the most common malignant neoplasms occuring worldwide. Although surgical resection still remains the treatment of choice for HCC, radiofrequency ablation (RFA) has emerged as reliable alternatives to resection. It is less invasive and can be repeated after short intervals for sequential ablation in case of multiple lesions. The most common complication of RFA is liver abscess, and bile duct injury such as bile duct stricture has been reported. This is a case report of a rare complication of abscesso-colonic fistula after RFA for HCC. The case was treated by percutaneous abscess drainage and antibiotics and occlusion of abscesso-colonic fistula with n-butyl-2-cyanoacrylate embolization.
Aged ; Anti-Bacterial Agents/therapeutic use ; Carcinoma, Hepatocellular/diagnosis/*surgery ; Catheter Ablation/*adverse effects ; Colonic Diseases/etiology/*therapy ; Drainage ; Embolization, Therapeutic ; Enbucrilate/*therapeutic use ; Humans ; Intestinal Fistula/etiology/*therapy ; Liver Abscess/etiology/ultrasonography ; Liver Neoplasms/diagnosis/*surgery ; Male ; Pseudomonas aeruginosa/isolation & purification ; Tomography, X-Ray Computed

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 ; Female ; Humans ; Klebsiella pneumoniae/isolation & purification ; Liver Abscess/diagnosis/*etiology/microbiology ; Middle Aged ; Peptic Ulcer Perforation/*complications/diagnosis ; Stomach Neoplasms/complications/*diagnosis/surgery ; Tomography, X-Ray Computed

No abstract availble.
Abdominal Abscess/diagnosis/*surgery ; Crohn Disease/etiology/surgery/*therapy ; Humans ; Length of Stay ; Predictive Value of Tests ; Recurrence ; Severity of Illness Index

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 ; Crohn Disease/*complications/drug therapy ; Diagnosis, Differential ; Drainage ; Hip Contracture/complications/*diagnosis/surgery ; Humans ; Male ; Psoas Abscess/*diagnosis/etiology/ultrasonography ; Tomography, X-Ray Computed