SULFANILAMIDE THERAPY FOR SUPPURATIVE PYLEPHLEBITIS AND LIVER ABSCESSES

Abstract

Suppurative pylephlebitis with multiple liver abscesses is an extremely grave disease. It most commonly follows acute appendicitis but also may complicate a great variety of intra-abdominal and rectal infections. The diagnosis may be difficult, and in many more cases the disease is recognized on the postmortem table rather than during life. The incidence of the condition has been appreciably smaller in recent times, owing to earlier operative intervention for acute appendicitis. In the older statistics necropsy reports of patients dead of acute appendicitis revealed pylephlebitis and liver abscesses in 4.7 per cent (Fitz),¹5 per cent (Armstrong)²and 5 per cent (Petren).³More recent analyses showed 0.4 per cent (Gatch and Durman)⁴and 0.3 per cent (Hawkes).⁵Colp,⁶in analyzing 2,841 cases of acute appendicitis, noted an incidence of 6.8 per cent of preoperative chills; in only a small fraction of these cases did