epyema

Acute cholecystitis requires a prompt diagnosis and early surgical treatment, either open or laparoscopic surgery. Currently, most of the patients can be treated by laparoscopic surgery.Delayed surgery of acute cholecystitis must be considered only if the patient has other clinical conditions such as congestive heart failure, other uncontrolled disease, and whenever cholecystitis is not complicated (epyema, perforation, gangrene, cholangitis, etc.) Percutaneous cholecystostomy by interventionist radiologist or surgical cholecystostomy must be considered in the therapeutic armamentarium in patients with poor clinical conditions...

The effectiveness of fibrinolytic treatment has been shown in cases of thoracic empyema in adults. In pediatric patients experience is, however, very limited. The aim of this study was to determine the success and complication rates of fibrinolytic treatment in thoracic empyema in children. A series of 25 consecutive children who had loculated pleural empyemas that did not respond to tube thoracostomy and antibiotics is presented. Their ages ranged from 1 to 12 years (mean 4.2). There were 19 boys and 6 girls, and all epyemas were postpneumonic...

We want to report on our experiences with the percutaneous trephination using a 2.35 mm round dental drill with serrated saws around it, a "Rosenbohrer". It is a methodically similar activity as described by J. Zentner [11]. From 1981 to 1992 519 patients were treated and 546 trephinations were performed. At the beginning this treatment was only used in connection with intracerebral bleedings and biopsies. In a considerable short time the indication could be extended to the subdural hematoma, tumor cyst, obstructive hydrocephalus as well as to the abscess and the subdural epyema...

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