A thorax computed tomography (CT) scan showed a large
abscess cavity in the mediastinum (Figure 1a).
Time for 50% Decrease in The Size of
Abscess Cavity in Days
The PCD was done by the introduction of a 12 Fr pigtail catheter in the
abscess cavity under ultrasound guidance utilizing the Seldinger technique.[8] The patient underwent ultrasound of the abdomen, and the features of the
abscess cavity were documented.
Transthoracic Echocardiogram showed a multiloculated para aortic
abscess cavity communicating with the MPA.
Once the pus has been aspirated, the
abscess cavity should be irrigated with approximately 50 mL of 1% lidocaine and adrenaline (or serum physiologic solution) (5).
In the examination with an anoscop, no internal orifice was seen in the rectum after saline-diluted hydrogene peroxide solution was given to the
abscess cavity. The first drainage incision was extended to the superiolateral direction where necrosis progressed.
The presence of yeast in the
abscess cavity required a median of 15 days (3-40 days) of catheterization whereas absence of yeast required a median of 7 days (3-45 days) of catheterization (P = 0.007).
Adhesions of the right upper lobe to the mediastinal pleura at the level of the azygocaval junction were bluntly mobilized and the
abscess cavity was identified.
Furthermore, the incised retropharyngeal
abscess cavity was connected by a small fistula to a second cervical abscess, medial to the sternocleidomastoid muscle.
Attention should be taken to ensuring the side holes of catheter were placed within the
abscess cavity. In this way, we avoid secondary liver infection.
PCD has been shown to be more effective than PNA in terms of success rate, clinical improvement, and time to achieve 50% reduction in
abscess cavity size [14].
As there was no clinical improvement after 48 hours, a second incision and drainage was performed under general anaesthetic, revealing a large
abscess cavity extending 10 cm into the right breast and 7 cm into the left mastectomy scar.