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Brain abscess following dilatation of esophageal stricture
D L Harp1, M Schlitt, J P Williams
1Department of Radiology, University of South Alabama Medical Center, Mobile 36617.
Insights
A brain abscess occurred in an 18-month-old child after esophageal dilatation for reflux. Early diagnosis via CT scan enabled prompt surgical aspiration, preventing complications.
Area of Science:
- Pediatric Neurology
- Gastroenterology
- Neurosurgery
Background:
- Esophageal dilatation is a common procedure for peptic strictures secondary to gastroesophageal reflux and hiatal hernias.
- Brain abscesses are rare but serious complications that can arise from various sources of infection.
- Pediatric cases of brain abscess following medical procedures require careful consideration of potential iatrogenic causes.
Observation:
- An 18-month-old male child developed a right parietal brain abscess.
- The abscess occurred subsequent to undergoing esophageal dilatation for a peptic stricture caused by a hiatal hernia with reflux.
- The clinical presentation, patient history, and computed tomography (CT) scan findings were crucial for diagnosis.
Findings:
- The combination of clinical history and CT imaging facilitated a confident preoperative diagnosis of brain abscess.
- The brain abscess was successfully treated by emergency surgical aspiration through a burr hole.
- Review of prior cases highlights the potential, though infrequent, association between esophageal dilatation and brain abscess.
Implications:
- This case underscores the importance of considering rare complications following common pediatric procedures.
- Prompt diagnosis and intervention, utilizing advanced imaging like CT scans, are critical for favorable outcomes in pediatric brain abscess.
- Further investigation into the mechanisms linking esophageal procedures to intracranial infections may be warranted.
Abstract:
A case of right parietal abscess following esophageal dilatation for peptic stricture secondary to hiatus hernia with reflux in an 18-month-old male child is reported. Prior cases of brain abscess following esophageal dilatation are reviewed. The combination of history, clinical findings, and computed tomography scan in the current case allowed confident preoperative diagnosis of brain abscess and allowed emergency treatment of the lesion by simple aspiration through a burr hole.