OBJECTIVETo analyze the clinical character, diagnosis and treatment of badly necrotic pyogenic infection in cervical part with pneumatosis of vomica.

METHODSThe clinical character, diagnosis and treatment of badly necrotic pyogenic infection in cervical part with pneumatosis of vomica of 46 cases were investigated retrospectively.

RESULTSLateral and bilateral neck infection cases were 38 and 8 respectively. 30 cases formed primary pyogenic infection in cervical part with pneumatosis of vomica, and 16 did from adjacent sites. Besides the characters of the acute infection, gas storage in deep cervical part abscess was notable. CT and B Ultrasonic examination provided useful informations such as sizes, shapes, capacity, extents of abscess and the relationship between the abscess and vessel or vital organ. Diagnosis puncture and germiculture were performed before and after operation. The results showed that 25 of 46 cases were infected by staphylococcus or streptococcus, and 21 cases did by other bacterium. Exploration and drainage treatments were performed. All cases were cured except 2 died.

CONCLUSIONDiagnostic puncture, CT and/or B Ultrasonic examination are essential for diagnosis and presurgical planning. Germiculture provides reliable evidence for finding pathogeny and therapy. The most possibilities of pyogenic infection with pneumatosis of vomica in cervical part are the action of aerogenic bacterium, infection both in cervical part and chest or swallowing movement of pharynx.

Abscess ; diagnosis ; microbiology ; therapy ; Cysts ; diagnosis ; microbiology ; therapy ; Humans ; Neck ; pathology ; Necrosis ; diagnosis ; microbiology ; therapy

A 62-yr-old woman with an autosomal dominant polycystic kidney disease (ADPKD) was admitted to our hospital for further evaluation of intermittent fever, nausea and left flank discomfort. The computed tomography (CT) scan revealed a gas-forming, infectious cyst of approximately 8.1 cm in size in left kidney lower pole. Escherichia coli was identified from the cyst fluid culture examination. Her symptoms improved only after the concomitant use of intravenous ciprofloxacin and an intracystic irrigation of ciprofloxacin through a percutaneous cystostomy drainage. Our case presents the successfully treated emphysematous cyst infection with combination of intravenous antibiotics and intracystic antibiotic therapy instead of surgical management.
Anti-Bacterial Agents/*therapeutic use ; Ciprofloxacin/*therapeutic use ; Cystostomy ; Cysts/microbiology ; Escherichia coli Infections/complications/*drug therapy ; Female ; Humans ; Injections, Intravenous ; Middle Aged ; Polycystic Kidney, Autosomal Dominant/complications/*diagnosis ; Therapeutic Irrigation ; Tomography, X-Ray Computed

OBJECTIVE: A retrospective analysis of the clinical efficacy on the surgery of maxillary sinus diseases via the endoscopic lateral nasal wall incision, and a discussion on the clinical application of this approach. METHOD: Eighteen cases of the maxillary sinus diseases diagnosed on the basis of the preoperative nasal endoscopy, CT scan or MRI, and pathologic finding. Among 13 patients underwent routine lateral nasal wall incision approach, including 4 of maxillary sinus hemorrhagic and necrotic polyps, 4 of maxillary sinus cyst, and 3 of the maxillary sinus fungal infection. Five patients underwent lateral nasal wall resection approach and thorough maxillary sinus lesions resection by nasal endoscope, including 3 of inverted maxillary sinus papilloma, a nasal sinus bone giant cell tumor and a spindle cell tumor. Patients were followed up for more than half a year, and the postoperative efficacy were observed. RESULT: The surgical cavity of the lateral nasal wall incision approach have luminal epithelium, well shapes of inferior turbinate, no recurrence of the lesion, and the lateral nasal wall resection patients with well luminal epithelium, without recurrence. All patients had no complications such as numbness, tears, etc. CONCLUSION Endoscopic incision of lateral nasal wall keep the nasolacrimal duct and inferior turbinate, help remove the entire sinus cavity lesion and retain the physiological function of the nasal cavity. Resection of the lateral nasal wall can reveal an ideal vision approach, which perform certain clinical value for the treatment of the inverted maxillary sinus papilloma and sinus cancer.
Cysts ; surgery ; Dissection ; methods ; Endoscopy ; Humans ; Magnetic Resonance Imaging ; Maxillary Sinus ; surgery ; Maxillary Sinus Neoplasms ; surgery ; Maxillary Sinusitis ; microbiology ; surgery ; Nasal Cavity ; surgery ; Papilloma, Inverted ; surgery ; Retrospective Studies ; Tomography, X-Ray Computed