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Empyema following intra-abdominal sepsis
The British Journal of Surgery
|September 1, 1984
Summary
Empyemas (pus in the chest) can arise from intra-abdominal sepsis (infection within the abdomen). Prompt diagnosis and surgical drainage of subphrenic abscesses are crucial for treating this thoracic complication.
Area of Science:
- Thoracic Surgery
- Abdominal Surgery
- Infectious Diseases
Background:
- Empyema can be a complication of intra-abdominal sepsis.
- Misdiagnosis is common, with symptoms often attributed to primary thoracic issues.
Purpose of the Study:
- To highlight the link between intra-abdominal sepsis and empyema.
- To emphasize the importance of diagnosing subphrenic abscesses in patients with empyema.
Main Methods:
- Retrospective review of ten patients with empyema secondary to intra-abdominal sepsis.
- Analysis of presenting symptoms, diagnostic challenges, and treatment outcomes.
Main Results:
- Twelve cases of empyema were identified in ten patients over nine years.
- Eight patients initially presented with symptoms wrongly attributed to thoracic pathology.
- Intra-abdominal sepsis was the underlying cause in all cases.
Conclusions:
- Empyema following abdominal surgery or with abdominal pain suggests ipsilateral subphrenic abscess.
- Limited thoracotomy with subdiaphragmatic extension provides optimal surgical access for drainage.
- This surgical approach offers the best chance for infection eradication across both cavities.