1/22. An unusual complication of minitracheostomy.A 72-year-old woman had a minitracheostomy inserted for sputum retention. This was undertaken by a relatively junior resident who opted to use an early model minitracheostomy kit Minitrach II. The following day the patients condition deteriorated and intubation was warranted, at which time it was apparent to senior staff that the minitracheostomy had been malpositioned. Ten days later, formal tracheostomy was performed under general anaesthesia. After incision, an abscess in the thyroid gland was found. histology subsequently revealed a Hurthle cell tumour of the thyroid. Thyroid abscess is exceedingly rare. It typically occurs in abnormal thyroid tissue and with a focus on infection. The combination of Hurthle cell adenoma and a foreign body (the minitracheostomy) was evidently causative in this instance. This complication of minitracheostomy insertion has not to our knowledge, previously been reported.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/22. Tubercular laryngeal abscess.tuberculosis, with its varied presentations and numerous complications, is a relatively common disease in developing countries like india. Amongst its many presentations, pulmonary tuberculosis is the commonest. A tubercular laryngeal abscess is an extremely rare entity. We report a 37-year-old male, diagnosed with a tubercular laryngeal abscess which was successfully treated under local anaesthesia by incision and drainage and in whom a tracheostomy could be avoided.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/22. Infratemporal and submasseteric infection following extraction of a non-infected maxillary third molar.A case is described where an otherwise fit young female patient developed a large submasseteric abscess following the uneventful extraction of a non-infected maxillary third molar under local anaesthesia with intravenous sedation. This report highlights the difficulty of clinical diagnosis especially in the early stages of the infection. This case also demonstrates the imaging modalities used to confirm the diagnosis. It is likely that the infection in this case arose in an infratemporal fossa haematoma resulting from reactionary haemorrhage. Careful injection of local anaesthetic with aspiration may prevent this complication arising. This is the first reported case of a submasseteric abscess associated with the extraction of a clinically non-infected maxillary third molar.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/22. Extradural abscess complicating extradural anaesthesia for caesarean section.Extradural abscess has been described infrequently as a complication of extradural anaesthesia and analgesia. We describe an abscess that developed 5 days after operation in a patient who had extradural anaesthesia for Caesarean section and postoperative analgesia, and review the literature on extradural abscess complicating extradural catheterization, including a discussion on pathogenesis, clinical presentation, diagnosis and management. There have now been 16 reported cases of extradural catheter-related extradural abscess. Only one previous case has been in obstetric practice, despite the widespread use of these techniques in this specialty. A disproportionate number of cases have involved thoracic catheters. Duration of catheterization ranged from 40 h to 6 weeks, the majority of catheters being in place for 5 days or less. The time from catheter placement to development of symptoms ranged from 72 h to 5 months. The causative organism was isolated in 11 cases: staphylococcus aureus was identified in nine (82%) and staphylococcus epidermidis in two (18%). Outcome was reported in 15 cases, of which seven (47%) had a full or near full recovery and eight (53%) had a persistent neurological deficit. One case was managed successfully without surgery. Fifty percent of all cases have been reported in the past 5 years. With the increasing use of extradural techniques for anaesthesia and analgesia, this serious complication may be seen more frequently in the future.- - - - - - - - - - ranking = 7keywords = anaesthesia (Clic here for more details about this article) |
5/22. A paraspinal abscess following spinal anaesthesia for caesarean section and patient-controlled epidural analgesia for postoperative pain.We present a rare case in which a healthy parturient developed a paraspinal abscess after spinal anaesthesia for caesarean section and epidural analgesia for postoperative pain management. The catheter was in situ for 58 h. Backache was the initial and major symptom. A concealed course with no neurological deficit resulted in a delayed diagnosis and treatment in this case. The infection was not diagnosed until 20 days after the removal of the epidural catheter when there was a purulent discharge from the epidural puncture site. Surgical drainage was required. Anaesthesiologists should be aware that serious epidural analgesia-related infections can happen in extra spinal-epidural spaces. Vigilance for these infections, especially in postpartum patients with backache, is needed.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |
6/22. Perianal abscesses due to ingested foreign bodies.Four cases of perianal abscesses due to foreign bodies (FBs) impacted in the anal canal are reported. The clinical presentation mimics common causes of acute anal pain. digital rectal examination under local or general anaesthesia and/or proctoscopy can establish the diagnosis, but may miss the presence of an FB. Incision and drainage of the abscess along with removal of the FB results in immediate pain relief and long-term cure. Impacted FBs must not be overlooked as an unusual cause of perianal abscess.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
7/22. Tuboovarian abscess mimicking intraligamentar uterine myoma and a intrauterine device: a case report.A case study is presented of tubo-ovarian abscess (pathohystological-verified actinomycosis) in a 41-year-old woman with an intrauterine device (IUD), which on US was found to be imposed upon an intraligamentary degenerated myoma (pyomyoma). The patient was afebrile, with normal vital functions (diuresis, blood pressure and pulse). Exposure of the abdominal cavity by lower transverse laparotomy performed under general endotracheal anaesthesia revealed slight uterus enlargement with normal left adnexa, whereas right adnexa were not exposed due to the soft tumour in the region of the right ligamentum latum, which displaced the urinary bladder and uterus leftward. The peritoneum fold was incised and deprepared, revealing a tumorous formation imposed onto the myoma or onto the 'cold' tubo-ovarian abscess. Total hysterectomy was then performed. Left adnexa showed a normal finding. Hemalaun-eosin staining of the preparation of the tumour capsule and tumour content showed colonies of threads extending radially to the surrounding tissues (drusen), surrounded by pus corpuscles, polymorphonuclears and macrophages containing lipids (sulfur granules). The patient was free from disease relapse at 2 years after the procedure. Thus, total abdominal hysterectomy and salpingoophorectomy, along with antibiotic therapy, were the definite mode of treatment for pelvic actinomycosis.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
8/22. Delayed presentation of an extradural abscess complicating thoracic extradural analgesia.Extradural abscess is a rare but recognized complication of extradural anaesthesia. Previous reports have been associated with a short time interval between extradural catheterization and presentation. We report a patient with rheumatoid arthritis, receiving steroid therapy, in whom an extradural abscess did not present until 23 days after the insertion of a thoracic extradural catheter to provide postoperative analgesia.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
9/22. Ultrasonically guided percutaneous drainage of breast abscesses.Four patients with breast abscesses developed during lactation were successfully treated by ultrasonically guided percutaneous drainage under local anaesthesia. Three patients continued nursing during and after the period of treatment and 2 patients were treated as out-patients. The cosmetic results were excellent. No recurrence of abscess was observed following the treatment. Ultrasonically guided percutaneous drainage as an alternative to surgery is discussed.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
10/22. spondylitis without epidural abscess formation following short-term use of an epidural catheter.A 42-year-old patient had undergone total hip replacement for aseptic femoral head necrosis 9 years previously. He now presented with loosening of the prosthesis and pseudoarthrosis sustained following a femoral shaft fracture 7 months earlier. A total hip replacement was carried out in general anaesthesia combined with an epidural catheter. The epidural catheter was removed on the third postoperative day, after which the patient complained of persistent lumbar pain which was associated with meningismus, fever, leucocytosis and a raised erythrocyte sedimentation rate. In spite of intensive laboratory and radiological investigation, 15 weeks elapsed before a radiological diagnosis of spondylitis of L1 and L2 could be made. Aspiration biopsy of the L1/L2 disc space yielded a growth of pseudomonas aeruginosa. Antibiotic therapy was begun immediately but could not prevent spread of infection to the adjacent disc-space T12/L1 and the vertebral body T12. The patient made a slow recovery and was discharged in a satisfactory condition wearing a lumbar brace some 9 months after the operation. No evidence of epidural abscess formation was found at any stage and no direct connection between the use of the epidural catheter and spondylitis could be established.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
| | Next -> |