Subphrenic abscess incision and drainage

An abscess occurs after infection of the infraorbital space, called an underarm abscess. Abscesses are more common in the right hepatic posterior space and the right hepatic anterior space, but other areas can also occur. The surgical approach for each gap is not identical, but the common principle that surgery should follow is to avoid contamination of the serosal cavity. Commonly used routes are: extrapleural extraperitoneal route (posterior extraperitoneal, anterior extraperitoneal route), transthoracic route and transperitoneal route. Treatment of diseases: underarm abscess Indication The inferior temporal space is below the diaphragm, the gap between the transverse colon and its mesentery and the peritoneum of the two side wall layers. The inferior temporal space is divided into the liver and the subhepatic space by the liver; further divided into the right upper anterior and right hepatic anterior and right hepatic anterior and posterior hepatic space (also known as the Morison sac) by the sacral ligament, the coronary ligament, and the triangular ligament. Left hepatic, left hepatic anterior, left hepatic posterior and other posterior gaps; between the two layers of the coronary ligament is the extraperitoneal space, between the right posterior liver and the bare area. Therefore, there are 7 gaps in the gap, 6 in the peritoneum, 1 in the peritoneum; 4 in the liver and 3 in the liver. An abscess occurs after infection of the infraorbital space, called an underarm abscess. Abscesses are more common in the right hepatic posterior space and the right hepatic anterior space, but other areas can also occur. The surgical approach for each gap is not identical, but the common principle that surgery should follow is to avoid contamination of the serosal cavity. Commonly used routes are: extrapleural extraperitoneal route (posterior extraperitoneal, anterior extraperitoneal route), transthoracic route and transperitoneal route. Surgical procedure 1. Position: supine position, quarter rib height. 2. Incision: Take a 2cm oblique incision under the costal margin, such as abscess on the left side to take the left inferior oblique incision, and abscess in the right side to take the right inferior oblique incision. The skin, subcutaneous tissue, rectus abdominis anterior sheath, rectus abdominis, transverse abdominis and transverse transverse fascia were excised layer by layer. If the abscess is close to the outside, it is not necessary to open the anterior rectus sheath and the rectus abdominis, but to cut the external oblique muscle, the internal oblique muscle, the transverse abdominis muscle and the transverse fascia. The peritoneum is revealed but not cut. 3. Drainage: According to the location of the abscess, use the index finger to separate the upper right or upper left between the peritoneum and the diaphragm, touch the wall of the abscess, puncture with a needle test, puncture the pus, cut the abscess along the puncture needle to the bottom of the abscess, release The pus is sent to culture for determination of drug susceptibility. Then use the index finger to extend into the abscess cavity to explore in all directions, estimate the depth and size of the abscess, and separate the fiber septum, smooth drainage. Then, a drainage strip is placed at the bottom of the abscess, and a long, short porous soft plastic tube is taken out of the body and properly fixed.

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