Intra-abdominal abscesses in children.
Forty-one intra-abdominal abscesses in 30 Nigerian children seen over a 2-year period at the Obafemi Awolowo University Teaching Hospital were studied prospectively to determine their location, aetiology, microbiology and clinical course. Thirty-four abscesses (83%) were intraperitoneal with the subphrenic spaces and pelvis being the commonly involved intraperitoneal sites. Six abscesses (15%) were retroperitoneal while there was only one visceral abscess (2%). Diseases of the gastrointestinal tract occurring in 20 patients (67%) were responsible for the majority of intraperitoneal abscesses, while suppurating external iliac adenitis was the major cause of retroperitoneal abscesses. There were 62 microbiological isolates, with 52% being anaerobic bacteria and 47% aerobic bacteria. A fungus, Candida, was isolated once (2%). Escherichia coli and Staphylococcus aureus were the commonest aerobic bacteria, while Bacteroides and anaerobic streptococci were the commonest anaerobes. Sixteen patients (53%) had a mixed flora of aerobic and anaerobic bacteria, while in seven patients each (23%) only aerobic or anaerobic bacteria were isolated. The mortality rate in this series was 23%. Association of an intra-abdominal abscess with remote organ failure, postoperative anastomotic leakage, non-localization of the abscess within the peritoneal cavity and gastrointestinal perforation due to typhoid enteritis was found to portend poor prognosis.
Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
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Ako-Nai
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Ajayi
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D000038:Abscess / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010532:Peritoneal Diseases / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D013158:Splenic Diseases / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality / Q000601:surgery*