PubMed · 7837622
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M Matsumoto, Y Muto, T Kusano. 1994. [Appendiceal abscess].. https://pubmed.ncbi.nlm.nih.gov/7837622/
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BACKGROUND: An experimental study was planned to evaluate the effect of bile alone and bile in combination with gallstones on intraperitoneal adhesion and abscess formation in the peritoneal cavity of the rat. METHODS: One hundred Sprague-Dawley rats were assigned to ten groups (n: 10). Groups 1-3 received a 1-ml intraperitoneal injection of saline, sterile bile, and infected bile. Groups 4-10 underwent a lower 5-mm midline abdominal incision. In groups 5, 7, and 9, a single gallstone (3-mm diameter) was placed in the right upper quadrant and injected with sterile saline, sterile bile, and infected bile, respectively. In groups 6, 8, and 10, four gallstones (3-mm diameter) were placed in the right upper quadrant together with sterile saline, sterile bile, and infected bile, respectively. Group 4 only underwent a 5-mm midline incision. All animals were sacrificed at the end of 4 weeks and the peritoneal cavity was carefully examined to investigate adhesions and abscess formation. The adhesions were graded according to Nair's gross pathologic grading of adhesions. The Kruskal-Wallis nonparametric test (KW) was used for statistical analysis. RESULTS: No intraabdominal lesions were noted in groups 1-3. The adhesion score was increased by number of stone and infected bile (G4: 3, G5: 3, G6: 11, G7: 7, G8: 10, G9: 15, G10: 18). But there was only a significant difference between the groups that received sterile saline+single stone (G5) and that receiving infected bile+four stones (G10) (KW: 24.3 P < 0.05). There was abscess formation in three rats in group 9 and two in group 10. CONCLUSIONS: In conclusion, infected bile in combination with multiple stones increases the gross grading of adhesion and intraabdominal abscess formation. Thus, in cases with multiple stones and infected bile, the dropped stones should be retrieved and the peritoneal cavity should be copiously irrigated during laparoscopic cholecystectomy.
Intrabdominal penetration with intestinal perforation is a relatively uncommon complication after liposuction. Seven cases have been reported in the literature, with a mortality rate > 50%. Here we present a case of a perforated viscus after suction lipoplasty of the abdomen using the tumescent technique. Multiple small-bowel enterotomies were made with the suction cannula. It is our hope that a heightened awareness of this potentially life-threatening complication will promote early and aggressive diagnosis and treatment of liposuction patients who present with gastrointestinal complaints in the early postoperative period.
We present two cases that support an infectious cause of inflammatory pseudotumor of the liver. Each patient had sepsis due to chronic abdominal abscesses, along with a liver mass. Both patients had exploratory celiotomy, and histologic examination of the liver mass revealed inflammatory pseudotumor of the liver. Evidence of a mixed bacterial/Actinomyces infection was noted in hepatic tissue sections in one patient, and Bacteroides caccae was cultured directly from the liver biopsy in the other patient. This is the first known report of bacteria being cultured from biopsy specimens of a hepatic pseudotumor and the only reported case of Actinomyces within a hepatic pseudotumor. Clinical and pathologic findings in these two cases indicate that an extrahepatic infectious source should be explored as a potential cause of inflammatory pseudotumor of the liver.