prikaz prve stranice dokumenta Lumbalni spinalni apcesi
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master's thesis
Lumbalni spinalni apcesi
2017. urn:nbn:hr:184:399139
Kovačič, Rok
University of Rijeka
Faculty of Medicine
Department of Neurosurgery

Cite this document

Kovačič, R. (2017). Lumbalni spinalni apcesi (Master's thesis). Rijeka: University of Rijeka, Faculty of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:184:399139

Kovačič, Rok. "Lumbalni spinalni apcesi." Master's thesis, University of Rijeka, Faculty of Medicine, 2017. https://urn.nsk.hr/urn:nbn:hr:184:399139

Kovačič, Rok. "Lumbalni spinalni apcesi." Master's thesis, University of Rijeka, Faculty of Medicine, 2017. https://urn.nsk.hr/urn:nbn:hr:184:399139

Kovačič, R. (2017). 'Lumbalni spinalni apcesi', Master's thesis, University of Rijeka, Faculty of Medicine, accessed 06 December 2024, https://urn.nsk.hr/urn:nbn:hr:184:399139

Kovačič R. Lumbalni spinalni apcesi [Master's thesis]. Rijeka: University of Rijeka, Faculty of Medicine; 2017 [cited 2024 December 06] Available at: https://urn.nsk.hr/urn:nbn:hr:184:399139

R. Kovačič, "Lumbalni spinalni apcesi", Master's thesis, University of Rijeka, Faculty of Medicine, Rijeka, 2017. Available at: https://urn.nsk.hr/urn:nbn:hr:184:399139

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Metadata
TitleLumbalni spinalni apcesi
AuthorRok Kovačič
MentorDarko Ledić (mentor)
Committee memberMira Bučuk (predsjednik povjerenstva)
Committee memberŽeljko Župan (član povjerenstva)
Committee memberTedi Cicvarić (član povjerenstva)
GranterUniversity of Rijeka
Faculty of Medicine
(Department of Neurosurgery)
Rijeka
Defense date and country2017-07-14, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Surgery
Abstract
Na spinalni apsces trebalo bi se posumnjati kod svakog pacijenta s bolovima u leđima, povišenom tjelesnom temperaturom i pojačanom osjetljivošću kralježnice. Rizični faktori za razvoj epiduralnog apscesa su dijabetes, intavenska zloupotreba droga, kronično bubrežno zatajenje, alkoholizam. SEA je češto povezan s spondilitisom i spondilocistitisom. Najčešće prezentirajući simptom je bol u leđima. Obično se prezentira probadajućom boli koja je lokalizirana iznad kralježnice. Bolno područje je mekano na dodir. Kasnije se pojave radikularni simptomi s distalnim neurološkim deficitom, retencijom urina i stola, abdominalnom distenzijom i slabošću koja može napredovat do para i kvadriplegije. Diferencijalno dijagnostički u obzir dolaze: meningitis, akutni transverzalni mijelitis, hernijacija diska i tumori leđne moždine. Do pojave spinalnog apscesa može doći hematogeno širenjem iz udaljenog izvora infekcije, ijatrogeno, širenjem infekcije s okolnih struktura i okolne površine tijela ili direktnom inokulacijom putem kirurških instrumenata, injekcija i katetera. Apsces može uzrokovati velik broj mikroorganizma. Za veliku većinu je odgovoran Staphylococcus aureus, slijede ga ostali aerobni i anaerobni streptokoki i Esherichia coli. Radiološka pretraga izbora za SEA je gadolinijom-pojačan MR i CT s kontrastom. Može se liječiti antibioticima. Antibiotska terapija traje od 4-8 tjedana, ovisno o tijeku bolesti. Može se liječiti i kirurškom drenažom gnoja i debridmanom granulacijskoga tkiva i, po potrebi, stabilizacijom okolnog koštanog tkiva. Letalitet je od 18-23%. Do smrtnog ishoda uglavnom dolazi zbog sepse i to kod pacijenata s više komorbiditeta.
Abstract (english)
Spinal abscess should be considered in a patient with back pain, fever and spine tenderness. The major risk factors are diabetes, intravenous drug abuse, chronic renal failure, alcoholism. It is often associated with vertebral osteomyelitis and intervertebral discitis. It usually presents with excruiating pain localized over spine, tender to percussion. Radicular symptoms follow with distal neurological deficits, often beginning with bowel or bladder disfunction, abdominal distension and weakness progressing to para and quadriplegia. Differential diagnosis of SEA includes meningitis, acute transverse myelitis, intervertebral disc herniation and spinal cord tumors. It can develop via hematogenous spread from a distant source such as skin or respiratory or urinary tract; from contiguous foci of infection such as the psoas muscle or vertebra; or by direct inoculation through spinal instrumentation, injection, or catheter placement. It can be caused by various microorganisms. The most common one is Staphylococcus aureus, followed by aerobic and anaerobic streptococcus and Esherichia coli. The radiographic tests of choice for diagnosing SEA are gadolinium-enhanced MR and CT scan with intravenous contrast. It can be treated with antibiotics. Depending on various factors, 4-8 weeks of antibiotic therapy is recommended. It can also be treated surgicaly by drainage of pus and debridement of granulation tissue, and bony stabilization if necessary. It is fatal in 18-23% of cases and death is generally due to overwhelming sepsis and typically occurs in patients with multiple comorbidities.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:184:399139
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsAccess restricted to students and staff of home institution
Terms of useLicence In copyright icon
Created on2018-06-14 10:53:38