Retroperitoneal abscess after urgent resection of the stomach in a geriatric patient treated with a surgical extraperitoneal approach – case report
Authors:
J. Šimo 1; P. Babál 2; V. Javorka 3
Authors‘ workplace:
I. chirurgická klinika Lekárskej fakulty Univerzity Komenského a Univerzitná nemocnica Bratislava, Staré Mesto, Bratislava
1; Ústav patologickej anatómie Lekárskej fakulty Univerzity Komenského a Univerzitná nemocnica Bratislava, Staré Mesto, Bratislava
2; I. rádiologická klinika Lekárskej fakulty Univerzity Komenského a Univerzitná nemocnica Bratislava, Staré Mesto, Bratislava
3
Published in:
Rozhl. Chir., 2023, roč. 102, č. 1, s. 37-41.
Category:
Case Report
doi:
https://doi.org/10.33699/PIS.2023.102.1.37–41
Overview
Retroperitoneal abscess after abdominal and retroperitoneal surgery is a relatively rare but serious complication that most often occurs as a result of a healing disorder in the postoperative period. The incidence is not high, in the literature the cases are mostly reported as case reports with a serious clinical course, high morbidity and mortality. The most important factor of effective treatment, after successful diagnosis by CT examination is rapid evacuation of the abscess and retroperitoneal drainage, in which mini-invasive surgical or radiological drainage dominate as methods of choice. Surgical drainage, burdened by higher morbidity and mortality is considered the last resort after failure of mini-invasive methods. In our case report, we present a case of retroperitoneal abscess, arising as a complication after gastric resection, which was evacuated and drained primarily surgically due to unsuitability for radiological intervention.
Keywords:
retroperitoneum – abscess – surgical drainage
Sources
1. Altemeier WA, Alexander JW, et al. Retroperitoneal abscess. Arch Surg. 1961;83:512–524. doi: 10.1001/archsurg. 1961.01300160024004.
2. Goenka AH, Shah SN, Remer EM. Imaging of the retroperitoneum. Radiol Clin North Am. 2012 Mar;50(2):333–355. doi:/10.1016/j.rcl.2012.02.004.
3. Mao X,Yu N, Jia X, et al. Imaging findings and clinical features of atypical retroperitoneal abscess caused by duodenal perforation: a case report and review of the literature. J Med Case Rep. 2020 Jul 17;14(1):105. doi:10.1186/s13256-020- 02393-x.
4. Ruscelli P, Renzi C, Polistena A, et al. Clinical signs of retroperitoneal abscess from colonic perforation: Two case reports and literature review Medicine (Baltimore) 2018 Nov;97(45):e13176. doi: 10.1097/ MD.0000000000013176.
5. Freeman ML, Werner J, van Santvoort HC, et al. International multidisciplinary panel of speakers and moderators. Interventions for necrotizing pancreatitis: summary of a multidisciplinary consensus conference. Pancreas 2012;41(8):1176–1194. doi: 0.1098/MPA. 0b013e318269c660.
6. Fagniez PL, Rotman N, Kracht M. Direct retroperitoneal approach to necrosis in severe acute pancreatitis. Br J Surg. 1989;76(3):264–267. doi: 10.1002/ bjs.1800760316.
7. Elias J Jr, Muglia VF. Elias J Jr, et al. Magnetic resonance imaging of the perirenal space and retroperitoneum. Magn Reson Imaging Clin N Am. 2019 Feb;27(1):77– 103. doi: 10.1016/j.mric.2018.08.007.
8. Bruno MJ. Dutch Pancreatitis Study Group. Improving the outcome of acute pancreatitis. Dig Dis. 2016;34(5):540–545. doi: 10.1159/000445257.
9. Van Santvoort HC, Besselink MG, Bakker OJ, et al. Dutch Pancreatitis Study Group. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010;362(16):1491–1502. doi: 10.1590/0100-69912017005015.
10. Tong Z, Li W, Yu W, et al. Percutaneous catheter drainage for infective pancreatic necrosis: is it always the first choice for all patients? Pancreas 2012;41(2):302–305. doi: 10.1097/mpa.0b013e318229816f.
11. Gomatos IP, Halloran CM, Ghaneh P, et al. Outcomes from minimal access retroperitoneal and open pancreatic necrosectomy in 394 patients with necrotizing pancreatitis. Ann Surg. 2016;263(5):992–1001. doi: 10.1097/SLA.0000000000001407.
12. Malhotra A, Biffl WL, Moore EE, et al. Western trauma association critical decisions in trauma: diagnosis and management of duodenal injuries. J Trauma Acute Care Surg. 2015;79:1096–1101. doi: 10.1097/ TA.0000000000000870.
13. Palumbo VD, Di Trapani B, Bruno A, et al. Recurrent retroperitoneal abscess after biliary tract surgery in an elderly patient: a minimally invasive nonsurgical approach and its consequences: a case report. J Med Case Rep. 2019 Feb 25;13(1):43. doi: 10.1186/s13256-019- 1973-3.
14. Sadatomo A, Koinuma K, Zuiki T, et al. Retroperitoneal abscess associated with a perforated duodenal ulcer. Clin J Gastroenterol. 2013;6(5):373–377. doi: org/10.1007/s12328-013-0417-7.
15. Mitáš L, Nevrtal T, Kunovsky L, et al. Spontánní retroperitoneální hematom – naše zkušenosti s aktivním chirurgickým přístupem. Rozhl Chir. 2019 Winter;98(1):23–26. doi: org/10.33699/ PIS.2019.98.
16. Moore AF, Hargest R, Martin M, et al. Intra- abdominal hypertension and the abdominal compartment syndrome. Br J Surg. 2004;91:1102–1110. doi: 10.1002/ bjs.4703.
17. Sunga KL, Bellolio MF, Gilmore RM, et al. Spontaneous retroperitoneal hematoma: Etiology, characteristics, management, and outcome. J Emerg Med. 2012;43:e157–161. doi: 10.1016/j. jemermed.2011.06.006.
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
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