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  • Title: Surgical treatment of sternoclavicular joint infections in cirrhotic patients.
    Author: Bakaeen FG, Huh J, Fagan SP, Bellows CF.
    Journal: Am J Surg; 2008 Jan; 195(1):130-3. PubMed ID: 18070732.
    Abstract:
    BACKGROUND: Cirrhotic patients with sternoclavicular joint (SCJ) infection pose a unique challenge for which there are no management guidelines. We reviewed our experience with this unusual infection in this high-risk patient population. METHODS: We performed a retrospective analysis of all patients with cirrhosis (n = 5) treated surgically for SCJ infection from January 1998 to July 2006. RESULTS: All infections were locally advanced with bone necrosis, complex abscess formation, or mediastinal involvement. En bloc SCJ resection was performed in 3 patients. A more conservative approach of incision and drainage with debridement was performed in 2 patients. Sepsis and/or pulmonary compromise occurred in all patients postoperatively and the surgical mortality rate was 40%. All deaths occurred after en bloc SCJ resection. CONCLUSIONS: Sternoclavicular joint infections in cirrhotic patients tend to be extensive in nature and pose a high surgical risk. Adequate surgical drainage and debridement may be better tolerated than a radical en block resection.
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