Ropniak is a reservoir of pus that is located in the cavities of the body. It can be located in the pleural cavity, and then we are dealing with a pleural empyema, it is also often located in the peritoneal cavity and is called a peritoneal empyema, so we distinguish specific empyema depending on the location of the lesion. What are the types of abscesses and how is it treated? What are the symptoms of an abscess?
Ropniak (Latin empyema) , unlike an abscess, it is not located directly in the tissues but in the body cavities. The above changes usually arise as a result of an inflammatory process taking place in a given area.
Ropniak - types
The most common abscesses include :
- pleural abscess
- peritoneal abscess
- joint abscess
- gallbladder abscess
- epidural empyema
- subdural empyema
- sinus abscess
- uterine abscess
- tubal abscess
- petroleum
- empyema of the lacrimal sac
Below, the causes, symptoms, and treatment methods of empyema are discussed using examples of pleural empyema and subdural empyema.
Pleural abscess
A pleural empyema forms secondary to the primary focus, which is pneumonia, as a result of reactive exudate accumulating in the pleura in the course of pneumonia. It may also be caused by postoperative bronchial or oesophageal leakage, esophageal rupture, pleural effusion aspiration, subphrenic abscess, secondary infection of partially clotted pleural hematoma.
In the initial phase, the infected fluid is thin and can be removed by drainage located in the low intercostal space. Unfortunately, the content of the empyema quickly thickens and encapsulates due to the fibrin build-up. In such a situation, surgical intervention and surgical drainage are necessary.
The empyema is usually located at the base of the pleural cavity and appears as a D-shaped shadow on the X-ray image. At this level, it is possible to perform surgery with videothoracoscopy or cut a fragment of the rib above the lowest part of the empyema, and then aspirate and clean the pleural cavity.
Depending on the patient's age and clinical condition, the tube can be left in the pleural cavity for several months and during this timethe content of the empyema is reduced until the lesion has completely disappeared. Such a procedure is used in elderly patients and patients in worse clinical condition.
The procedure is different in younger people and in better clinical condition. In such patients, the use of open thoracotomy with decorrection allows for complete removal of the fibrous empyema cavity and the altered parts of the pleural cavity. This is a much faster method that allows you to restore the proper functioning of the lungs to a greater extent.
Subdural empyema - symptoms and treatment
The brain may also be the site for an empyema, such as a subdural empyema, which arises as a complication of frontal sinusitis. This results in a number of clinical symptoms such as:
- headaches
- epileptic seizures
- focal neurological deficits
Also appear:
- meningeal symptoms, ie neck stiffness - resistance of the neck muscles and pain when the head is passively tilted forward; a measure of stiffness is the number of fingers that can be placed between the patient's chin and sternum
- Brudziński's symptom - reflex flexion in the knee and hip joints with passive tilting of the patient's head
- Kernig's symptom - tested in a supine patient: the lower limb bent at the knee joint is bent at the hip joint; you feel resistance when you try to straighten it in the knee joint.
In the case of treating lesions located in the central nervous system, surgical intervention should be initiated as soon as possible.
The clinical problem is, in addition to the encapsulated oil reservoir, cerebral edema and a tendency to venous sinus thrombosis. The abscess evacuation procedure is performed using the technique of image guided surgery with the use of a frame or with the use of frameless systems, craniotomy or orifice trepanation is performed.
At the same time, empirical antibiotic therapy is administered and the purulent material is Gram stained and cultured for drug susceptibility. Dexamethasone is given to reduce swelling in the brain. Neurological complications in the form of post-infectious epilepsy often occur, which is why the patient is often forced to take antiepileptic drugs throughout his life.
- Rectal abscess and anal fistula
- Tooth abscess: causes, symptoms, treatment
- Retrograde abscess: causes, symptoms, treatment
- Multiple abscesses - causes, symptoms and treatment