Spinal epidural abscess presenting as acute abdomen in a child

Tyson, George W.; Grant, Alan; Strachan, W E

doi:10.1002/bjs.1800660103

Cited by 18 publications

(7 citation statements)

References 12 publications

(11 reference statements)

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“…(A) LP can cause intradural contamina tion, as clearly demonstrated by the present series and the experience of others [27][28][29], However, suboccipital or high cervical lateral puncture can reasonably be assumed to over come this risk.…”

Section: Discussionmentioning

confidence: 73%

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Spinal Epidural Abscesses

Ravicovitch¹,

Spallone²

1982

Eur Neurol

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42 cases of spinal epidural abscesses were operated on in the years 1957–1980, among approximately 8.000 spinal operations. Staphylococcus aureus was the microorganism most commonly isolated from infected material and the primary source of infection was in most cases cutaneous and/or subcutaneous lesions. Typical clinical history included back pain and fever, with progressive nerve root and spinal cord involvement. The cases were divided into three groups according to the operative findings: (a) acute abscesses; (b) chronic abscesses, and (c) mixed or subacute abscesses. These three groups differed as to duration of illness, incidence of meningeal signs, white blood cell concentration and lumbar puncture results. Plain X-rays were positive in 20% of cases. Myelography, whose indications were maximally restricted, gave in some instances inaccurate results. Treatment consisted of extensive laminectomy of all the affected spinal segments, and drainage of infected material. Local and systemic appropriate antibiotic therapy was also given. An average of 16 daily sessions of barotherapy, consisting of 1.7–2.0 atm given in 40–60 min, were administered in the last 9 cases. When compared with the patients to which barotherapy was not given, these cases showed a lower rate of permanent disability (11 vs. 21%), even if they were managed under less favorable clinical and neurological conditions. These results seem to support a favorable role of hyperbaric treatment in the management of spinal epidural abscesses. Early diagnosis and appropriate management remain essential in order to have satisfactory treatment results.

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Section: Discussionmentioning

confidence: 73%

“…In fact the rarity of epidu ral abscesses in children is widely recognized [1,3,8,29], Staphylococcus was found to be the most common causative microorganism in this and other series [2, 5. 9, 15, 16, 20, 25].…”

Section: Discussionmentioning

confidence: 99%

Spinal Epidural Abscesses

Ravicovitch¹,

Spallone²

1982

Eur Neurol

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“…In the case reported by Tyson et al, a 7-year-old girl presented to the hospital with a 6-day history of malaise, anorexia, and aching over the anterior aspects of both thighs, and a two day history of central abdominal pain and intermittent vomiting (9). On admission, the patient had a temperature of 38.4°C (101.1°F), and laboratory studies showed elevation in the peripheral WBC count of 16,000/mm 3 (exact differential not reported) and in the erythrocyte sedimentation rate of 58 mm/h.…”

Section: Discussionmentioning

confidence: 91%

“…One common hypothesis is that the visceroparietal reflexes that cause abdominal discomfort via inflammation of the lower thoracic nerve roots can be exacerbated by intraspinal disease (9,12). In the case report described above, the epigastric abdominal pain experienced by the patient most likely represented referred pain in the T7-T9 dermatomal distribution-the area extending from just below the costal margins to the level of the umbilicus.…”

Section: Discussionmentioning

confidence: 96%

Spinal epidural abscess presenting as intra-abdominal pathology: a case report and literature review

Bremer

Darouiche

2004

The Journal of Emergency Medicine

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“…In one case, abdominal pain was so severe as to warrant a diagnostic laparotomy 6. Two published case reports7 8 describe spinal epidural abscesses presenting as abdominal pain in paediatric patients, one of which was initially diagnosed as acute appendicitis 8…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation of a spinal epidural abscess

Noy

George

2012

BMJ Case Reports

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A 59-year-old female patient presented with a 3-day history of abdominal pain and confusion. She had no significant medical history. On admission her Glasgow Coma Scale was 14/15; she was septic and examination revealed right upper quadrant tenderness. She deteriorated quickly, becoming acidotic and hypoxic, and was sedated, intubated and transferred to the intensive care unit. Blood tests revealed raised inflammatory markers and blood cultures grew Staphylococcus aureus. Initial CT head revealed raised intracranial pressure and she was treated for meningoencephalitis. Repeat CT head 12 days later showed resolving oedema, and a lumbar puncture was attempted. This drew only frank pus and an abscess was suspected. CT spine confirmed a possible paravertebral abscess. Once extubated, MRI spine was possible which confirmed spinal epidural abscesses-1 month postadmission. These were rapidly drained by the neurosurgical team and the patient is currently receiving rehabilitation in a specialist centre.

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Spinal epidural abscess presenting as acute abdomen in a child

Cited by 18 publications

References 12 publications

Spinal Epidural Abscesses

Spinal Epidural Abscesses

Spinal epidural abscess presenting as intra-abdominal pathology: a case report and literature review

Unusual presentation of a spinal epidural abscess

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