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Biomedical subjects

K Kjossev

Publications and source records attributed to K Kjossev.

9 recordsLinked to original sources
PubMed1997

Toxic shock syndrome and necrotizing fasciitis complicating neglected sacrococcygeal pilonidal sinus disease: report of a case.

PURPOSE: This study was conducted to report the rare combination of necrotizing fasciitis and toxic shock syndrome, which both complicated neglected sacrococcygeal pilonidal sinus disease. METHODS: A case report is presented. RESULTS: We describe the rare case of a previously healthy adult male patient who developed necrotizing fasciitis and toxic shock syndrome associated with Streptococcus pyogenes and Bacteroides fragilis. Patient's response to emergency surgery followed by repeated debridements of necrotic tissue, together with aggressive fluid resuscitation, broad-spectrum antibiotic coverage, and hyperbaric oxygenation was good. CONCLUSION: This case serves again as a clear reminder that neglected pilonidal sinus disease can lead to unusual and life-threatening consequences.

Bacteroides Infections↗
PubMed1997

Palisade dorsoventral lavage for neglected peritonitis.

A modification of the procedure of laparostomy with palisade dorsoventral lavage for treating neglected peritonitis is described. It consists of adding a polyethylene foil to cover the intestines and thus avoiding the direct contact between them from one side, and the suction drains and the palisade laparostomy screen from the other. Between 1988 and 1995, 19 patients with neglected peritonitis (APACHE II scores from 12 to 42; mean 22.3) were managed using this modified technique. A total of 81 reexplorations were done (average, 4.3 reexplorations per patient). The technique proved effective (21% mortality, n = 4). No intestinal perforations, fistulas, or residual pus collections occurred among survivors or among those who died. Primary fascial closure was achieved in all survivors and during an 18-months followup, no incisional hernia occurred. Based on these results, we believe this technique is extremely useful when both laparostomy and continuous peritoneal irrigations are considered in patients with neglected peritonitis.

APACHE↗
PubMed1997

Peptostreptococcal myonecrosis of extraperitoneal origin--a life-threatening complication of pelvic ring disruption.

This report illustrates the clinical and pathological findings of anaerobic streptococcal myonecrosis following extraperitoneal rectal injury in a 28-year-old patient with traumatic pelvic ring disruption. Four days following admission, the patient underwent laparotomy, debridement and drainage of the left-sided abdominal wall and presacral space for gross surgical emphysema and streptococcal anaerobic myonecrosis. The specificity of this infection and its impact on the diagnosis and treatment of the condition are briefly discussed. Accent is given to early recognition, appropriate medical and surgical management, and hyperbaric oxygenation as an additive measure.

Adult↗
PubMedDate not supplied

Stercoral perforation of the normal colon: report of five cases.

A series of five consecutive patients with stercoral perforation of the colon is presented. Four of the patients had free perforation and one had an abscess between the splenic flexure, spleen and surrounding organs, a yet unreported entity. All patients underwent emergency surgery including laparostomy with repeated explorations and lavages in two of them. The ethiology, pathophysiology and treatment of the condition are updated. A graphic algorithm for decision-making in appropriately dealing with stercoral perforation of the colon is proposed.

Aged↗
PubMedDate not supplied

Sciatic hernia.

The case of a young female patient with advanced gastric carcinoma and right-sided sciatic hernia is reported. Palliative gastrectomy was considered the only option. The reducibility of the hernia was confirmed at laparotomy but the herniorraphy was performed using the gluteal approach. Based on their previous experience with this entity, the authors compare the advantages and drawbacks of the approaches and methods for repair of sciatic hernias.

Adult↗