Helvetica chirurgica acta
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Helvetica chirurgica acta · Apr 1994
Case Reports[Secondary peritonitis after negative computerized tomography in blunt abdominal trauma].
Diagnostic peritoneal lavage has widely been replaced by emergency sonography in the evaluation of blunt abdominal trauma. CT is generally performed in cases without major hemodynamic instability in order to define non-operative treatment of injuries of the parenchymatous organs or to precise the extension of retroperitoneal, spinal and pelvic lesions. ⋯ Despite discrete clinical signs, these lesions were only diagnosed at the stage of obvious secondary peritonitis. These cases should remind us the limits of CT in the evaluation of abdominal visceral lesions in blunt trauma.
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The term "necrotizing soft tissue infections" describes a group of limb and life-threatening infections. Depending on the tissue level, microbiology and clinical course the necrotizing soft-tissue infections are classified in primary located infections to the subcutaneous level and fascia--like hemolytic streptococcus gangrene, necrotizing fasciitis, gram-negative synergistic necrotizing cellulitis, clostridium-cellulitis, anaerobic non-clostridium-cellulitis and in primary located infections to the muscle--like clostridium myonecrosis and streptococcal myositis. Between 1989 and 1992, 17 patients with necrotizing soft-tissue infections were treated at the Department of Surgery, University Hospital of Zurich. ⋯ The average hospitalisation was 41 days (13-137 days) whereas 10 patients required between 4 and 53 days intensive care (average 18.3 days). Necrotizing soft-tissue infections are severe illnesses which are underestimated in the primary phase due to atypical or minor primary signs. The infections can be caused by a variety of bacteria and are spreading rapidly.(ABSTRACT TRUNCATED AT 250 WORDS)