Transabdominal liver abscess incision and drainage

According to the hepatic lobe where the abscess is located, the right inferior oblique incision is selected, and the right rectus abdominis incision or the upper abdomen incision is made. Check the size, color and texture of the liver after laparotomy. The inflammatory edema of the liver where the abscess is located may have varying degrees of adhesion to the surrounding area. The surface of the liver may be bulging, dark red, sputum and lumps, which may fluctuate. The suspicious area should be tested and puncture. The needle should be inserted from the nearest liver surface. The dry gauze pad is used around the puncture point. The puncture is taken, and the extracted pus is sent to the bacterial culture and the sensitivity of the bacteria is determined. Keep the needle in the abscess and insert a hemostat along the needle to expand the drainage. At the same time, use the aspirator to suck out the pus in the abscess, and be careful not to contaminate the abdominal cavity. Extend the finger to explore the septum and separate the space in the abscess for drainage. The cavity is built into the porous rubber tube, and the surrounding of the rubber tube is surrounded by a large omentum to separate the abdominal cavity and external cigarettes are drained. Double cannula drainage can also be placed for postoperative irrigation, adequate drainage, and shortened disease duration. Treatment of diseases: liver abscess amoebic liver abscess Indication 1. A bacterial liver abscess with a large abscess. 2. Amoebic liver abscess secondary infection or non-surgical treatment is invalid. 3. Hepatic cysticercosis secondary infection. Contraindications The age of the body is weak, the vital organs such as the heart and lungs are poor, and the surgery does not restore hope. Preoperative preparation 1. Full support for treatment: a small amount, multiple blood transfusions, fluid replacement, correction of water and electricity balance disorders and hypoproteinemia. 2. Anti-infective treatment: According to the determination of bacterial sensitivity, the pathogenic strain is estimated, sensitive antibiotics are selected or combined with broad-spectrum antibiotics. 3. Positioning: In order to further confirm the diagnosis and determine the surgical approach, the abscess can be determined according to physical signs, ultrasound, x-ray or liver abscess puncture. Generally, tenderness, edema of the lower chest wall, and tenderness of the intercostal space are often abscesses. Surgical procedure According to the hepatic lobe where the abscess is located, the right inferior oblique incision is made, the right rectus abdominis incision or the upper abdomen incision. Check the size, color and texture of the liver after laparotomy. The inflammatory edema of the liver where the abscess is located may have varying degrees of adhesion to the surrounding area. The surface of the liver may be bulging, dark red, sputum and lumps, which may fluctuate. The suspicious area should be tested and puncture. The needle should be inserted from the nearest liver surface. The dry gauze pad is used around the puncture point. The puncture is taken, and the extracted pus is sent to the bacterial culture and the sensitivity of the bacteria is determined. Keep the needle in the abscess and insert a hemostat along the needle to expand the drainage. At the same time, use the aspirator to suck out the pus in the abscess, and be careful not to contaminate the abdominal cavity. Extend the finger to explore the septum and separate the space in the abscess for drainage. The cavity is built into the porous rubber tube, and the surrounding of the rubber tube is surrounded by a large omentum to separate the abdominal cavity and external cigarettes are drained. Double cannula drainage can also be placed for postoperative irrigation, adequate drainage, and shortened disease duration. A liver abscess that is larger in the abscess: 1. The omentum can be inserted into the abscess after the pus is exhausted to promote the closure of the abscess. 2. If the abscess is located above, it has been collapsed in the face, or is about to be worn. It must be drained at the top. If the liver tissue is thinner under the wall of the abscess, it must be bluntly separated under the liver at the same time. Otherwise, the postoperative treatment will be delayed due to poor drainage. If the pus is thick, a thin plastic tube can be placed in the abscess for postoperative lavage and antibiotics. complication peritonitis.

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