Adverse effect of splenectomy in experimental peritonitis.

Patients undergoing splenectomy have increased operative morbidity and mortality, especially when associated with gastrointestinal surgery or injury. This present study was designed to assess the effect of splenectomy on mortality in a polymicrobial fecal peritonitis model and evaluate therapy with antibiotic (cefoxitin) or immunomodulation (glucan). Human stool-barium (0.

Clostridial sepsis: unusual clinical presentations.

We present four cases exhibiting the widely diverse nature of clinical infections due to anaerobic Clostridium perfringens. These cases exemplify the need for a thorough initial physical examination, immediate Gram staining of fluid from involved tissue, and recognition of the severity of the disease in any patient who has early septic deterioration after elective or emergency surgical procedures. Management of these infections includes both high-dose parenteral penicillin therapy and aggressive initial surgical debridement of all involved tissues.

Intracranial placement of nasogastric tube: an unusual complication.

We have described a case of intracranial placement of a nasogastric tube in a patient with severe head trauma. This complication occurs as a result of either passage through a traumatic defect in the cribriform plate associated with a severe head injury or direct penetration through an intact cribriform plate by an improperly passed rigid nasogastric tube. In combative semicomatose or comatose patients, oral placement may be preferable to nasogastric placement of a gastric tube.

Severe systemic sepsis resulting from neglected perineal infections.

Eleven patients with severe necrotizing fasciitis involving the soft tissues and muscles of the perineum, abdominal wall, buttocks, and thighs were treated on the Tulane Surgical Service in New Orleans between 1979 and 1981. The etiologic factor in ten of these patients was a neglected or inadequately drained perirectal abscess. Three of the 11 patients died of the disease and ensuing multiple organ failure, for a mortality of 27%.