Successful Conservative Management of a Retroperitoneal Abscess With a Sinus to the Colon: A Case Report

Abstract

A sinus between the colon and a retroperitoneal abscess is a rare entity that usually occurs as a complication of a primary condition such as Crohn's disease, radiation enteritis, or diverticular disease. Herein, we report a 72-year-old woman with a retroperitoneal abscess and a sinus formation between the abscess and the colon after an iatrogenic injury to her left colon. The retroperitoneal abscess was detected 1 week after the patient had undergone a left nephroureterectomy for recurrent ureteral cancer. The patient's general performance status allowed conservative management with antibiotics and percutaneous drainage. The abscess resolved, and the sinus closed after 3 weeks of treatment. In the absence of surgical pathology in the colon, and if the patient's general condition is good enough to tolerate conservative management, treatment using antibiotics plus percutaneous drainage is effective for cases of retroperitoneal abscess with a sinus between the colon and abscess.

A Challenging Case of Retroperitoneal Abscess in a Post-Partum Crohn’s Disease Patient

“…Previous case reports have reported CD patients presenting with unique clinical manifestations of retroperitoneal abscesses. One CD patient presented with sudden onset of leg claudication due to a psoas abscess and fistula [ 8 ]. Another presented with back pain and was found to have a retroperitoneal abscess with formation of a fistula between the abscess and colon [ 9 ].…”

“…Studies show that it takes 12.7 days on average to establish the diagnosis of retroperitoneal abscess [ 10 , 11 ], so although our patient eventually did well, her delay in care was well outside the expected range. In the above-mentioned study examining worldwide variation in retroperitoneal abscess formation, all 7 patients who died from their infections received delayed care [ 8 ].…”