J Korean Surg Soc.  2010 Jan;78(1):58-61. 10.4174/jkss.2010.78.1.58.

Retroperitoneal Abscess in a Patient with Acute Appendicitis

• Jang JH
• Hwang KT
• Chung JK
• Jung IM
• Heo SC
• Ahn YJ
• Ahn HS

• KMID: 1775447
• DOI: http://doi.org/10.4174/jkss.2010.78.1.58

Abstract

Although acute appendicitis is one of the most common surgical diseases, very rare but serious complications can occur including retroperitoneal abscess complicated by acute appendicitis. The early diagnosis of retroperitoneal abscess is often difficult and delayed because its clinical course is often insidious and does not present with typical symptoms of acute appendicitis. We experienced a 65-year-old male patient who was diagnosed with acute appendicitis with retroperitoneal abscess. As the retroperitoneal abscess was not fully removed via emergency operation, postoperative percutaneous drainage was performed but not effective. Retroperitoneal abscess can be cured by 2nd operation with retroperitoneal approach. We report here an unusual case of retroperitoneal abscess complicated by acute appendicitis.

Keyword

Acute appendicitis; Complication; Retroperitoneal abscess

MeSH Terms

Abscess
Aged
Appendicitis
Drainage
Early Diagnosis
Emergencies
Humans
Male

Figure

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  Fig. 1 Preoperative plain abdominal films show mild small bowel ileus and widening of right flank stripe with air density (arrow) in supine (A) and erect (B) view.

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  Fig. 2 Preoperative computed tomography scan of the abdomen and pelvis demonstrates ill-defined appendix and periappendiceal abscess formation with internal air density (arrow) (A). Right retroperitoneal fluid collection with internal air density (arrow head) is found along lateral side of abdominal cavity (B).

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  Fig. 3 Computed tomography scan shows markedly enlarged abscess cavity in right posterior pararenal space of the retroperitoneum (arrow), 1 week after 1st operation (A), but retroperitoneal abscess cavity is near complete absence 1 week after 2nd operation (B).

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