Posterior extraperitoneal hepatic abscess incision and drainage

Start at the back of the 12th rib on the back and start at a height of 3cm from the midline of the back. Make a slanted incision to reach the 12th rib tip, cut the skin, subcutaneous tissue, latissimus dorsi and lower posterior serratus, and cut the 12th rib membrane. The periosteum of the upper, lower and deep ribs of the ribs were removed with a periosteal stripper, and the ribs of 4 to 5 cm were excised. At the level corresponding to the first lumbar spine, the rib bed was cut along the ribs, and the diaphragm was cut to indicate the outside of the renal fat sac. The extraperitoneal space is separated upwards, over the level of the adrenal gland, and can reach the naked part of the liver. In the center of the liver tissue where the edema is inflamed and infiltrated, it can be touched to a soft place. After the puncture can be taken, the hemostatic forceps can be used. Expand the drainage port, insert the hose into the drainage tube, and fix it properly. 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 Old and frail, with severe heart disease, can not tolerate liver abscess incision and drainage. 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 Start at the back of the 12th rib on the back and start at a height of 3cm from the midline of the back. Make a slanted incision to reach the 12th rib tip, cut the skin, subcutaneous tissue, latissimus dorsi and lower posterior serratus, and cut the 12th rib membrane. The periosteum of the upper, lower and deep ribs of the ribs were removed with a periosteal stripper, and the ribs of 4 to 5 cm were excised. At the level corresponding to the first lumbar spine, the rib bed was cut along the ribs, and the diaphragm was cut to indicate the outside of the renal fat sac. The extraperitoneal space is separated upwards, over the level of the adrenal gland, and can reach the naked part of the liver. In the center of the liver tissue where the edema is inflamed and infiltrated, it can be touched to a soft place. After the puncture can be taken, the hemostatic forceps can be used. Expand the drainage port, insert the hose into the drainage tube, and fix it properly. complication Impaired liver function.

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