Öz
kliniğimizde subfrenik abse tanısı alarak cerrahi tedavi görmüş 43 vaka ge- riye yönelik olarak incelenmiştir. Etyoloji açısından ülkemizin bir özelliği olarak karaciğer kist hidatiklerinin sık görülmesi bunun bir komplikasyonu olarak seri mizdeki sekonder subfrenik abselerin % 39.3 den sorumlu olması dikkat çekici- dir. Buna karşın akut apandisit ve mide rezeksiyonları sonrası oluşan subfrenik abseler, serimizde, literatür bilgilerinin aksine ilk sıraları almamaktadır. Bunun muhtemel nedenleri akut apandisiti erken cerrahi girişim, etkili antibiotikler ve gastro-duodenal ülserlerde günümüzde çoklukla vagotomi-drenaj ameliyatlarını uygulanmasıdır.
Subfrenik abselerde mortalitenin genellikle yüksek olması nedeniyle bu kom- plikasyondan korunma birinci derecede önem kazanır. Tedavinin temel ögeleri ise erken yeterli drenajdir. Ekstraseröz drenaj işlemi bu yönlerden en çok seçilen, mortalite oranı en düşük yöntem olarak dikkati çekmektedir.
Anahtar Kelimeler
Etik Beyan
-
Destekleyen Kurum
-
Proje Numarası
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Teşekkür
-
Kaynakça
- Ariel IM, Kazarian KK : Classification Diagnosis and Treatment of Subphrenic Abscess, Review Surg 28 : 1-1971
- Barnard HL : An Adress on Surgical Aspects of subphrenic Abscess, Brit Med J : 429- 1909 : 0
- Barnard HL : Surgical Aspects of Subphrenic Abscess, Brid Med Jour 1 : 371-1908
- Bonfils-Roberts ve ark : Treatment of Subphrenic Abscess, Surg Clin N Amer 55 : 1361-1975
- Bonfils-Roberts EA, Nealon TF : Jr : Subphrenic Abscess, Cqmparison Between Operative and Antibiotic Management, Ann Surg 180 : 209-1973
- Carter R, Brewer LA : Subphrenic Abscess, A Thoraco-Abdominal Clinical Complex, the Changing picture with Antibiotics, Amer J Surg 108 : 165-1964
- Clairmont P, Meyer P : Subphrenic Abscess, Acta Chir Scandinav 60, 55-1926
- Clagget OT, Tinney WS : Subphrenic Abscess, Amer J Surg 66 : 189-1944
- Dineen P, Mc Sherry CK : Subdiafrağmatik Abscess, Ann Surg 155 : 506-1962
- Elsberg CMA : A contribution to the Pathology Diagnosis and treatment of Subphrenic Abscess after Appendicitis, Ann Surg 34 : 729-1901
- Faxon HH : Subphrenic Abscess : Report of 111 Consecutive Operative Cases, New Eng J M 222 : 289-1940
- Fraser K : Subprenic Abscess, J Thorac Cardio vasc, Surg 33 : 776-1957
- Halâsz NA : Subphrenic Abscess, A Report of 111 consecutive eases, N Eng J. Med 22 : 269-1946
- Harley HRS : Subphrenic Abscess, Oxford Blackwell 1965
- Harley HRS : Subphrenic Abscess, Thorax 4 : 1-1949
- Harley HRS : Peri and Intrahepitic Abscess, Proc R Soc Med 63 : 319-1970
- Holmes F : Intraperitoncal and Intrapleural Pressure : An Experimental Study Anest - hesia 11 : 69-1965 .
- Hochberg LA : Diagnostic Criteria For Subprrenic Abscess, Ann Intern Med 17 : 183, 1942 :
- Maingot R : Abdominal Operations, vol 11 pp 1172 Subphrenic Abscess, Appleton Centruy Croft London 1968 -
- Martineta : Des Varietes Anatomiques et d’Abces sous-phrenique, There de Paris, 1898
- Magilligan DJ : Subphrenic Abscess, Arch Surg 96 : 14-1968
- Mc Worter GL : Subphrenic Amscess, Cyclopedia of Medicine Davis Comp, Philadelphia 4 : 601, 1974
- McWhorter GL : Subphrenic Abscess, Arch Surg 35 : 341-1937 . Miller WT and Talman EA : Subphrenic Abscess, Amer J Rontgen X 101 : 1961, 1969
- Moore HD : Subphrenic Abscess, Ana Surg 158 : 240-1963
- Nather K : Die Bingriffe beim Subphrenichen Asbecs, Ed : Schmidt Operative Chirürgie Springer Berlin 977-1943
- Neuhof H Schlossmann NC : Left Subphrenic Abscess, Surg Gynec Obstet 75 : 751-1942
- Ochsner A, Graves AM : Subphrenic Abscess, An analysis of 3372 Collected and Personal Cases, Surg Gynec Obstet 66 : 426-1968
- Ochsner A, De Bakey ME : Subphrenic Abscess Review and A;ıalysix of 3608 Collected and Personal Cases, Surg Gynec Obstet 66 : 426-1938
- Ochsner A ve ark : Subphrenic Abscess, Ann Surg 91 : 544-1930
- Posileth/Wait RW : Periti Sherman NJ ve ark. : Pathogenesis of Peritonitis 11, Surgery 61 : 393-1967
- STRODE J E: Subphrenic Abscess, Surgery 44:1054-1958.
- Surakiatchanukul S, Ram D Medhira : Current Patterns of Subphrenic Abscess, Amer J Surg 125 : 718-1973
- Thorex P : Six Subphtenic Spaces, Applicd Anatomy and surgical Considerations, Surçgery 21 : 739-1947
- Volkmann Richard von : Die-Chirgie, Kirschner-Nordman IV S 173 Urbar-Schwarzenberg Berlin 1941
- Whipple AO : Study of subdiaphragmatic Abscess, With an analysis of 32 Cases Ann J Surg 40 : 1-1926
Öz
Forty three cases of subprenic abscesses diagnosed and surgically treated in our clinic studied retrospectively. Hydatid cysts of the liver has been shown to be responsible for the 39.3 % of the secondary subphrenic abscesses. On the other hand, acute appendicitis and gastric resections, as ethiological factors, were less striking in contrast to the literature ratios. This might be due to the use of wide- spectrum antibiotics and early surgical intervention for acute appendicitis and wide spread preference of vagotomy +drainage methods for gastro-duodenal ulcers. Barly diagnosis and proper drainage has primary importance in order to re- duce the mortality rate of subphrenic abscesses. Among many drainage methods extraserous drainage approach has been proven to be method of choise with less mortality rates.
Anahtar Kelimeler
Etik Beyan
-
Destekleyen Kurum
-
Proje Numarası
-
Teşekkür
-
Kaynakça
- Ariel IM, Kazarian KK : Classification Diagnosis and Treatment of Subphrenic Abscess, Review Surg 28 : 1-1971
- Barnard HL : An Adress on Surgical Aspects of subphrenic Abscess, Brit Med J : 429- 1909 : 0
- Barnard HL : Surgical Aspects of Subphrenic Abscess, Brid Med Jour 1 : 371-1908
- Bonfils-Roberts ve ark : Treatment of Subphrenic Abscess, Surg Clin N Amer 55 : 1361-1975
- Bonfils-Roberts EA, Nealon TF : Jr : Subphrenic Abscess, Cqmparison Between Operative and Antibiotic Management, Ann Surg 180 : 209-1973
- Carter R, Brewer LA : Subphrenic Abscess, A Thoraco-Abdominal Clinical Complex, the Changing picture with Antibiotics, Amer J Surg 108 : 165-1964
- Clairmont P, Meyer P : Subphrenic Abscess, Acta Chir Scandinav 60, 55-1926
- Clagget OT, Tinney WS : Subphrenic Abscess, Amer J Surg 66 : 189-1944
- Dineen P, Mc Sherry CK : Subdiafrağmatik Abscess, Ann Surg 155 : 506-1962
- Elsberg CMA : A contribution to the Pathology Diagnosis and treatment of Subphrenic Abscess after Appendicitis, Ann Surg 34 : 729-1901
- Faxon HH : Subphrenic Abscess : Report of 111 Consecutive Operative Cases, New Eng J M 222 : 289-1940
- Fraser K : Subprenic Abscess, J Thorac Cardio vasc, Surg 33 : 776-1957
- Halâsz NA : Subphrenic Abscess, A Report of 111 consecutive eases, N Eng J. Med 22 : 269-1946
- Harley HRS : Subphrenic Abscess, Oxford Blackwell 1965
- Harley HRS : Subphrenic Abscess, Thorax 4 : 1-1949
- Harley HRS : Peri and Intrahepitic Abscess, Proc R Soc Med 63 : 319-1970
- Holmes F : Intraperitoncal and Intrapleural Pressure : An Experimental Study Anest - hesia 11 : 69-1965 .
- Hochberg LA : Diagnostic Criteria For Subprrenic Abscess, Ann Intern Med 17 : 183, 1942 :
- Maingot R : Abdominal Operations, vol 11 pp 1172 Subphrenic Abscess, Appleton Centruy Croft London 1968 -
- Martineta : Des Varietes Anatomiques et d’Abces sous-phrenique, There de Paris, 1898
- Magilligan DJ : Subphrenic Abscess, Arch Surg 96 : 14-1968
- Mc Worter GL : Subphrenic Amscess, Cyclopedia of Medicine Davis Comp, Philadelphia 4 : 601, 1974
- McWhorter GL : Subphrenic Abscess, Arch Surg 35 : 341-1937 . Miller WT and Talman EA : Subphrenic Abscess, Amer J Rontgen X 101 : 1961, 1969
- Moore HD : Subphrenic Abscess, Ana Surg 158 : 240-1963
- Nather K : Die Bingriffe beim Subphrenichen Asbecs, Ed : Schmidt Operative Chirürgie Springer Berlin 977-1943
- Neuhof H Schlossmann NC : Left Subphrenic Abscess, Surg Gynec Obstet 75 : 751-1942
- Ochsner A, Graves AM : Subphrenic Abscess, An analysis of 3372 Collected and Personal Cases, Surg Gynec Obstet 66 : 426-1968
- Ochsner A, De Bakey ME : Subphrenic Abscess Review and A;ıalysix of 3608 Collected and Personal Cases, Surg Gynec Obstet 66 : 426-1938
- Ochsner A ve ark : Subphrenic Abscess, Ann Surg 91 : 544-1930
- Posileth/Wait RW : Periti Sherman NJ ve ark. : Pathogenesis of Peritonitis 11, Surgery 61 : 393-1967
- STRODE J E: Subphrenic Abscess, Surgery 44:1054-1958.
- Surakiatchanukul S, Ram D Medhira : Current Patterns of Subphrenic Abscess, Amer J Surg 125 : 718-1973
- Thorex P : Six Subphtenic Spaces, Applicd Anatomy and surgical Considerations, Surçgery 21 : 739-1947
- Volkmann Richard von : Die-Chirgie, Kirschner-Nordman IV S 173 Urbar-Schwarzenberg Berlin 1941
- Whipple AO : Study of subdiaphragmatic Abscess, With an analysis of 32 Cases Ann J Surg 40 : 1-1926
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Nöroloji ve Nöromüsküler Hastalıklar |
| Bölüm | Makaleler |
| Yazarlar | |
| Proje Numarası | - |
| Yayımlanma Tarihi | 1 Temmuz 1980 |
| Yayımlandığı Sayı | Yıl 1980 Cilt: 33 Sayı: 1 |