TITLE

Air Following Splenic Embolization: Infection or Incidental Finding?

AUTHOR(S)
Haan, James; Bochicchio, Grant; Kramer, Mary; Scalea, Thomas
PUB. DATE
December 2003
SOURCE
American Surgeon;Dec2003, Vol. 69 Issue 12, p1036
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The use of splenic embolization for nonoperative management has increased. With increased use of this adjunct, a new and frequent finding has been air within the areas of infarction in patients with or without clinical signs of infection. The purpose of this study was to determine if air within areas of splenic infarction is pathologic of infection or rather an incidental finding. A retrospective review over the past 3 years of inpatients undergoing splenic embolization and having pre- and postembolization abdominal computed tomography scans were reviewed for the findings of free air as well as any clinical signs of infection. A total of 96 consecutive patients were included. Of these, 12 had evidence of infarction with air. Six of these patients had undergone distal embolization with intraparenchymal air, but no symptoms. These were successfully observed. Two patients demonstrated subcapsular air/fluid levels, which underwent drainage with splenic preservation. Cultures were negative for infection. The remaining 4 underwent splenectomy. Of these, all had large collections of air. Two of these 4 spleens were infected: 1 with alpha-hemolytic Streptococcus and one with Clostridia perfringens. The remainder was sterile. This gave an overall infection rate of 17 per cent of patients with evidence of air. This yield increased to 33 per cent if the patient had symptoms and 50 per cent in those with large amounts of air and symptoms. Overall, we feel that air following embolization is a concern, but does not constitute infection. Patients with large amounts of air and signs and symptoms of infection will have a far higher infectious rate, 50 per cent in this limited series. In these patients, evaluation for infection is indicated; that being percutaneous sampling versus splenectomy.
ACCESSION #
11856053

 

Related Articles

  • Multimicrobial Sepsis Including Clostridium perfringens after Chemoembolization of a Single Liver Metastasis from Common Bile Duct Cancer. Eckel, Florian; Lersch, Christian; Huber, Wolfgang; Weiss, Wolfgang; Berger, Hermann; Schulte-Frohlinde, Ewert // Digestion;2000, Vol. 62 Issue 2/3, p208 

    A 65-year-old woman underwent resection of a distal common bile duct carcinoma (Whipple’s procedure). Twelve months later a single hepatic metastasis was detected and a chemoembolization was performed. Immediately after chemoembolization the patient developed a multimicrobial sepsis...

  • Clostridium perfringens sepsis with intravascular hemolysis following laparoscopic... Bush, George Wayne; Clements, Ronald H. // American Surgeon;Apr1996, Vol. 62 Issue 4, p326 

    Describes a case of clostridium perfringens sepsis. Symptoms; Mortality rate; Treatment regimen.

  • TISSUE INJURY BY THE TOXIN OF CL. WELCHII, TYPE A. Kellaway, C. H.; Trethewie, E. R. // Australian Journal of Experimental Biology & Medical Science;Mar1941, Vol. 19 Issue 1, p17 

    The toxin of Cl. welchii type A fails to cause the liberation of histamine or S.R.S. from perfused organs but sets free pigment and coagulable proteins from the perfused liver, and adenyl compounds and an inactivating enzyme from the perfused liver and hind limbs of the rabbit. The...

  • Aerobic and Anaerobic Microbiology of the Immersion Chilling Procedure During Poultry Processing. Voidarou, C.; Vassos, D.; Kegos, T.; Koutsotoli, A.; Tsiotsias, A.; Skoufos, J.; Tzora, A.; Maipa, V.; Alexopoulos, A.; Bezirtzoglou, E. // Poultry Science;Jun2007, Vol. 86 Issue 6, p1218 

    The development of treatments to reduce bacterial numbers on poultry carcasses is important for the overall hygienic quality of birds. The important washing effect of the immersion chilling procedure is discussed. Systematic monitoring of fecal bacterial indicators as well as some classic...

  • Embryonated chicken eggs as an alternative model for mixed Clostridium perfringens and Eimeria tenella infection in chickens. Alnassan, Alaa; Shehata, Awad; Kotsch, Marianne; Lendner, Matthias; Daugschies, Arwid; Bangoura, Berit // Parasitology Research;Jun2013, Vol. 112 Issue 6, p2299 

    The chorioallantoic membrane (CAM) of chicken embryo eggs is a suitable model for viral and bacterial infections. In the present study, a new approach for testing the pathogenesis and virulence of Clostridium perfringens and Eimeria tenella dual infections as a model using the CAM of embryonated...

  • A Painful Shoulder. Mehta, Sanjay // Clinical Infectious Diseases;12/1/2004, Vol. 39 Issue 11, p1713 

    The article presents information on the diagnosis of Clostridium perfringens septic arthritis. Clostridial infections appear to have a more fulminant course in patients with cancer. A retrospective review of a 12-year period performed at the M.D. Anderson Cancer Center Houston, TX) found that...

  • Acute intravascular haemolysis in Clostridium perfringens septicaemia. Strobel, E.; Smith, Jeanette M. // JAMA: Journal of the American Medical Association;6/22/94-6/29/94, Vol. 271 Issue 24, p1890f 

    Studies a hemolytic case of Clostridium perfringens septicemia in a man with acute lymphoblastic leukemia. Presence of leukemia, anemia and thrombocytopenia; Chemotherapeutic regimen; Occurrence of hemolysis; Computed tomography of the skull; Liberation of T-antigen as a sign of bacterial...

  • Microbiological Studies On Enteritis Caused By Clostridium Perfringens Type A, In Sheep In Saudi Arabia. Al-Humiany, Abdulrahman A. // Journal of Applied Sciences Research;Feb2012, Vol. 8 Issue 2, p836 

    Clostridium perfringens type A was isolated from 89 out of 121 sheep showing diarrhea, 7 (5.8%) sheep as a single infection and 82 sheep (67.7%) sheep as a mixed infection with coccidia}. These sheep showed signs of enteritis and were suspected to have enterotoxaemia followed by sudden death...

  • Nosocomial diarrhea caused by Clostridium perfringens in the Tsukuba-Tsuchiura district, Japan. Masahiro Watanabe; Shigemi Hitomi; Tatsuo Sawahata // Journal of Infection & Chemotherapy (Springer Science & Business;Jun2008, Vol. 14 Issue 3, p228 

    Abstract  We examined the incidence of nosocomial diarrhea caused by Clostridium perfringens enterotoxin (CPEnt) in three tertiary hospitals in the Tsukuba-Tsuchiura district, Japan. In addition, isolated strains were genomically characterized. Among 294 stool specimens submitted for C....

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics