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PubMedDate not supplied

Carcinoma of the oesophagus. Anastomotic leaks after manual sutures--incidence and treatment.

Progress in the development of suture materials results in a lower rate of fistulas. Modern techniques for the diagnosis of leakage (contrast study, CT-scan) allow for an early diagnosis and adequate therapy: if possible conservative therapy with drainage of the abscess, adapted antibiotic therapy and parenteral and enteral nutrition are the best methods. In the case of necrosis of the transplant, reoperation permits enables extra time for reconstruction. All the technical possibilities of reconstruction must be known. It is necessary to apply prophylactic precautions to avoid leakage of the anastomosis on the oesophagus.

Anastomosis, Surgical↗

PubMedDate not supplied

[Peritonitis with Mycobacterium avium complex in a patient with alcoholic cirrhosis].

Before highly active antiretroviral therapy were available, disseminated Mycobacterium avium complex infection was common in adults with HIV. Diagnosis was often made by blood culture in these immunocompromised patients. Although Mycobacterium avium complex disease can involve any organ of the body, infection of serosal surfaces is very rare. Mycobacterium avium complex peritonitis is rare and usually occurs in immunocompetent patients with chronic ambulatory peritoneal dialysis. We report a case of Mycobacterium avium complex peritonitis in a patient with alcoholic cirrhosis with no evidence of HIV infection. Diagnosis was made by culture of a lymphocytic ascites which showed Mycobacterium avium complex at 4 weeks. Interestingly, blood and hepatic cultures remained negative. At three months, marked improvement occurred with antimycobacterial treatment, so that orthotopic liver transplantation could be performed.

Anti-Bacterial Agents↗