RECURRENT RETROPERITONEAL ABSCESS AFTER BILIARY TRACT SURGERY IN AN ELEDERLY PATIENT: A MINIMALLY INVASIVE NONSURGICAL APPROIACH AND ITS CONSEQUENCES: A CASE REPORT
| Autor: | M. Messina, Mario Feo, Benedetto Di Trapani, Giovanni Tomasello, Attilio Ignazio Lo Monte, Bernardo Molinelli, Simone Tomasini, Antonio Bruno, Vincenzo Davide Palumbo |
|---|---|
| Přispěvatelé: | Palumbo,VD, Di Trapani,B, Bruno,A, Feo,M, Molinelli,B, Tomasini,S, Lo Monte,AI, Messina,M, Tomasello,G |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Nonsurgical drainage Fistula Liver Abscess Subphrenic abscess lcsh:Medicine Case Report Minimally invasive procedures Hepatic abscess 030204 cardiovascular system & hematology Inferior vena cava Diagnosis Differential 03 medical and health sciences Postoperative Complications 0302 clinical medicine Recurrence Humans Medicine Retroperitoneal Space Abscess Aged Interventional radiology business.industry lcsh:R Lumbosacral Region General Medicine medicine.disease Empyema Hernia Abdominal Surgery Biliary Tract Surgical Procedures Settore MED/18 - Chirurgia Generale medicine.anatomical_structure Lumbar hernia medicine.vein 030220 oncology & carcinogenesis Drainage Abdomen Female Right Lumbar Region Biliary Tract Surgery Hepatic abscess lumbar hernia interventional radiology minimally invasive procedure nonsurgical drainage case report Tomography X-Ray Computed business |
| Zdroj: | Journal of Medical Case Reports Journal of Medical Case Reports, Vol 13, Iss 1, Pp 1-8 (2019) |
| Popis: | Introduction Hepatic abscess can be defined as an encapsulated collection of suppurative material within the liver parenchyma. Hepatic abscess can be distinguished as pyogenic, amebic, or fungal. Biliary tract disease remains the most common cause of hepatic abscess today, and the most common complications range from pleural effusion, empyema, and bronchohepatic fistula to subphrenic abscess and rupture into the peritoneal cavity, stomach, colon, vena cava, or kidney. A large abscess compressing the inferior vena cava and the hepatic veins may result in Budd-Chiari syndrome. In this report, we present a rare case of hepatic abscess with an unusual evolution that was treated with a noninvasive approach. Case presentation A 79-year-old Caucasian woman underwent endoscopic bile stone extraction and laparoscopic cholecystectomy. Six months later, a hepatic abscess in association with bilateral effusion was diagnosed. The prompt imaging-guided drainage solved the case. Three years later, she came to our attention complaining of dull, diffuse abdominal pain and high body temperature (38 °C). A retroperitoneal abscess was diagnosed that was spreading to the right lateral wall of the abdomen and extending across the muscular wall to the subcutaneous layer. The fluid collection also involved the right pleural cavity, forming an empyema. Also in this case, an imaging-guided drainage was performed, and the patient’s clinical picture resolved in a few days. The retroperitoneal abscess recurred 14 months later, and it was dealt with using the same treatment. Three months from the last follow-up, the patient came back to our attention with an evident swelling of her right lumbar region. Computed tomography revealed a right inferior lumbar hernia comprising adipose tissue and the right kidney. A surgical intervention was recommended to the patient, but, owing to her poor general health, she refused any invasive approach. Conclusions Retroperitoneal abscess is an uncommon complication of biliary tract surgery and represents a potential cause of death, especially in those patients with multiple diseases. Prompt drainage is crucial to the treatment. Failure in eliminating the primary infective focus could bring complications and, in general, a weakness of lumbar muscular wall, even resulting in a rare case of lumbar hernia. |
| Databáze: | OpenAIRE |
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