Extra-abdominal lumbar abscesses caused by retroperitoneal gastrointestinal perforations through the lumbar triangle of Petit: report of two cases diagnosed by CT

Coulier, B; Gogoase, Monica; Ramboux, A.; Pierard, Frédéric

doi:10.1007/s00261-012-9847-9

Cited by 8 publications

(8 citation statements)

References 18 publications

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“…phritis, perianal abscess, colon cancer, perforation, or postsurgical complications (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Extra-abdominal primary sources of infection with retroperitoneal spread have also been described, most commonly involving necrotizing fasciitis of the extremities.…”

Section: Teaching Pointsmentioning

confidence: 97%

“…There is an emerging role for interventional radiology and percutaneous drainage of focal abscess collections; this procedure may be used in conjunction with conventional aggressive therapy. Therapeutic decisions should be reached on the basis of a multidisciplinary approach, with the indication for percutaneous drainage evaluated on a case-by-case basis (11,47).…”

Section: Treatment and Outcomementioning

confidence: 99%

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Retroperitoneal Fasciitis: Spectrum of CT Findings in the Abdomen and Pelvis

et al. 2015

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Retroperitoneal fasciitis is a rare but potentially lethal complication of infection. Early diagnosis is crucial and is usually made when there is a high degree of clinical suspicion combined with characteristic imaging findings leading to early surgical intervention. Computed tomography (CT) can play a central role in demonstrating early findings, assessing the extent of disease to help determine the best surgical approach, identifying the primary source of infection, and evaluating the treatment response. The possible presence of retroperitoneal fasciitis should be considered in patients presenting with symptoms of sepsis, including pain that is disproportionate with the clinical abnormality. When retroperitoneal fasciitis is suspected, emergency CT can facilitate early diagnosis and evaluation of the extent of disease. Common findings at CT include fascial thickening and enhancement, muscular edema, fat stranding, fluid collections, and abscess formation. Gas tracking along fascial planes in the retroperitoneum is the hallmark of retroperitoneal fasciitis but is not seen in all cases. Another important clue to the diagnosis is asymmetric involvement of the retroperitoneal fascial planes and deep tissues. Fasciitis in the retroperitoneum may originate from infected retroperitoneal organs or from infection that spreads along indirect and/or direct pathways from a primary source elsewhere in the body. Findings of indirect tracking and transgression of fascial planes may indicate more severe infection associated with the necrotizing form of retroperitoneal fasciitis. Despite aggressive antibiotic treatment, early and repeated surgical débridement may be required to remove nonviable tissue in patients with the necrotizing form of retroperitoneal fasciitis. Awareness of the anatomy of the retroperitoneum, potential routes of spread of infection, and the spectrum of CT findings in retroperitoneal fasciitis is needed to achieve prompt diagnosis and guide treatment.

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Section: Teaching Pointsmentioning

confidence: 97%

Section: Treatment and Outcomementioning

confidence: 99%

Retroperitoneal Fasciitis: Spectrum of CT Findings in the Abdomen and Pelvis

et al. 2015

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“…However, as the authors comment, this kind of intra-abdominal inflammation spread is extremely rare. In general, the retroperitoneal space communicates with the leg along the inguinal ligament, the femoral canal, the sciatic foramen, or the obturator foramen and, through these pathways, retroperitoneal inflammations may spread to the leg [7]. …”

Section: Discussionmentioning

confidence: 99%

Abdominal Wall Abscess due to Acute Perforated Sigmoid Diverticulitis: A Case Report with MDCT and US Findings

Rafailidis

Gavriilidou

Liouliakis

et al. 2013

Case Reports in Radiology

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Perforation of the inflamed diverticula is a common diverticulitis complication. It usually leads to the formation of a local abscess. In some rare cases, the inflammatory process may spread towards extra-abdominal sites like the anterior or posterior abdominal wall or the thigh and form an abscess in these sites. We present the case of a 73-year-old man with a history of pain at the lower left quadrant of the abdomen for 20 days and a visible mass in this site. Ultrasonography and computed tomography revealed this mass to be an abscess of the abdominal wall which had been formed by the spread of ruptured sigmoid diverticulitis by continuity of tissue through the lower left abdominal wall. Local drainage of the abscess was performed and the patient was discharged after alleviation of symptoms and an uneventful course. We also discuss causes of abdominal wall abscesses along with the possible pathways by which an intra-abdominal abscess could spread outside the abdominal cavity.

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“…In our case, the perforation appeared as a left lumbar area abscess of three-month duration, for which the patient did not seek treatment before, as he did not present any other symptoms. Apart from our case, only two other cases have been described clearly as an abscess in the lumbar area following diverticulum perforation in the literature ( Table 1 ) [ 11 , 12 ]. It is believed that recurrent attacks of diverticulitis provoke scarring and adhesion formation, so localized perforations and abscesses may appear instead of generalized peritonitis [ 4 ].…”

Section: Discussionmentioning

confidence: 78%

Left Colon Diverticulitis Presenting as Perforated Lumbar Abscess: A Case Report and Review of the Current Literature

Paramythiotis

Kofina

Papadopoulos

et al. 2015

Case Reports in Gastrointestinal Medicine

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Diverticular perforation is a common complication of diverticulitis and can lead to the creation of abscesses. The presence of such abscesses on the abdominal wall is rare and can lead to misdiagnosis. We present the case of a patient with abdominal pain and the formation of a large left lumbar abscess due to perforation of a diverticulum of the left colon and our surgical treatment of choice with favorable results.

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Extra-abdominal lumbar abscesses caused by retroperitoneal gastrointestinal perforations through the lumbar triangle of Petit: report of two cases diagnosed by CT

Cited by 8 publications

References 18 publications

Retroperitoneal Fasciitis: Spectrum of CT Findings in the Abdomen and Pelvis

Retroperitoneal Fasciitis: Spectrum of CT Findings in the Abdomen and Pelvis

Abdominal Wall Abscess due to Acute Perforated Sigmoid Diverticulitis: A Case Report with MDCT and US Findings

Left Colon Diverticulitis Presenting as Perforated Lumbar Abscess: A Case Report and Review of the Current Literature

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