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Empyema and lung abscess as complication of a perforated appendicitis in a pregnant woman.
MedLine Citation:
PMID:  23047071     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The development of empyema as a result of an intra-abdominal pathology is a rare condition.
PRESENTATION OF CASE: We present a 31-year-old woman at 28 weeks' gestation who was referred to our hospital with diagnosis of pneumonia with pleural effusion. She presented with signs of septicemia and fetal distress. A thoracic-abdominal-pelvic CT-scan showed a right pleural effusion with a retroperitoneal collection in contact with the pleural space. Due to her critical condition, immediate surgical exploration and pregnancy interruption was decided. The fetus was delivered by cesarean with satisfactory vitality. After abdominal exploration, a retrocecal appendicular abscess was evidenced and appendectomy was performed. Subsequently, the right chest was accessed through a posterolateral thoracotomy. An empyema with lung abscess and purulent fluid accessing from the retroperitoneum at the posterior pleural space was found. Due to parenchymal compromise, a right inferior lobectomy was performed. The patient had an uneventful recovery and was discharged at postoperative day 10.
DISCUSSION: A septic condition in a pregnant patient with significant thoraco-abdominal infection requires an aggressive approach, with interruption of pregnancy and urgent exploration of the chest and abdomen.
CONCLUSION: When an empyema is developed in absence of lung disease or other intrathoracic cause, intra-abdominal origin should be considered.
Authors:
Agustin Dietrich; Matias Nicolas; Jose Iniesta; David Eduardo Smith
Publication Detail:
Type:  Journal Article     Date:  2012-09-19
Journal Detail:
Title:  International journal of surgery case reports     Volume:  3     ISSN:  2210-2612     ISO Abbreviation:  Int J Surg Case Rep     Publication Date:  2012  
Date Detail:
Created Date:  2012-10-29     Completed Date:  2012-10-30     Revised Date:  2013-04-02    
Medline Journal Info:
Nlm Unique ID:  101529872     Medline TA:  Int J Surg Case Rep     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  622-4     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Hospital Italiano of Buenos Aires, Argentina. Electronic address: agustin.dietrich@hospitalitaliano.org.ar.
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