Transthoracic subdiaphragmatic abscess incision and drainage

This method is not commonly used, and is only used when there is a high abscess in the anterior space of the right liver or an abscess in the extraperitoneal space. Treatment of diseases: mediastinal abscess subgingival abscess Indication It is used in the high abscess or the extraperitoneal space abscess in the anterior superior hepatic space. Contraindications There are major diseases in the liver. Preoperative preparation 1, generally no special preparation. For patients with poor general condition, supportive care should be taken, including nutrition, infusion and antibiotics. Blood transfusion if necessary. 2, ultrasound examination, determine the location of the abscess. Surgical procedure 1. Position: with the posterior extraperitoneal axillary abscess incision and drainage. 2. Incision: According to the abscess site, along the midline of the 8th, 9th or 10th ribs, make an incision parallel to the ribs, about 8 ~ 9cm long, cut a section of ribs, reveal the pleura. 3. Drainage: According to the adhesion of the pleura and diaphragm, it is divided into first and second stage surgery. If there is adhesion, it can be directly puncture at the adhesion site. After obtaining the pus, the adhesion of the pleura and diaphragm is cut along the puncture needle to drain the abscess. If no adhesion is formed, the pleura is rubbed with a iodine cotton ball, and the wound is filled with dry gauze to cause adhesion of the pleural horn pleura to the diaphragm, and the second operation is performed after 3 to 5 days. The second stage operation is to open the pus, enter from the original incision, through the adhesion of the pleura and diaphragm, first puncture with a needle, pull out the pus, cut along the puncture needle, then extend the finger into the abscess to separate the fiber septum, place drainage article. complication Abscesses occur after infection of the infraorbital space.

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