RECURRENT RETROPERITONEAL ABSCESS AFTER BILIARY TRACT SURGERY IN AN ELEDERLY PATIENT: A MINIMALLY INVASIVE NONSURGICAL APPROIACH AND ITS CONSEQUENCES: A CASE REPORT

Giovanni Tomasello, Vincenzo Davide Palumbo, Attilio Ignazio Lo Monte, Antonio Bruno, Benedetto Di Trapani, Simone Tomasini, Giovanni Tomasello, Mario Feo, Bernardo Molinelli, Vincenzo Davide Palumbo, Benedetto Di Trapani, Simone Tomasini

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Abstract

Introduction: Hepat 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 broncohepatic 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-years-old Caucasian woman underwent endoscopic bile stone extraction and laparoscopic colecystectomy. 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 healt, she refused any invasive approach. Conclusions: retroperitoneal abscess is an uncommon complication of biliary tract surgery and represent 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.
Original languageEnglish
Number of pages8
JournalDefault journal
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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RECURRENT RETROPERITONEAL ABSCESS AFTER BILIARY TRACT SURGERY IN AN ELEDERLY PATIENT: A MINIMALLY INVASIVE NONSURGICAL APPROIACH AND ITS CONSEQUENCES: A CASE REPORT. / Tomasello, Giovanni; Palumbo, Vincenzo Davide; Lo Monte, Attilio Ignazio; Bruno, Antonio; Di Trapani, Benedetto; Tomasini, Simone; Tomasello, Giovanni; Feo, Mario; Molinelli, Bernardo; Palumbo, Vincenzo Davide; Di Trapani, Benedetto; Tomasini, Simone.

In: Default journal, 2019.

Research output: Contribution to journalArticle

Tomasello, Giovanni ; Palumbo, Vincenzo Davide ; Lo Monte, Attilio Ignazio ; Bruno, Antonio ; Di Trapani, Benedetto ; Tomasini, Simone ; Tomasello, Giovanni ; Feo, Mario ; Molinelli, Bernardo ; Palumbo, Vincenzo Davide ; Di Trapani, Benedetto ; Tomasini, Simone. / RECURRENT RETROPERITONEAL ABSCESS AFTER BILIARY TRACT SURGERY IN AN ELEDERLY PATIENT: A MINIMALLY INVASIVE NONSURGICAL APPROIACH AND ITS CONSEQUENCES: A CASE REPORT. In: Default journal. 2019.
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abstract = "Introduction: Hepat 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 broncohepatic 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-years-old Caucasian woman underwent endoscopic bile stone extraction and laparoscopic colecystectomy. 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 healt, she refused any invasive approach. Conclusions: retroperitoneal abscess is an uncommon complication of biliary tract surgery and represent 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.",
author = "Giovanni Tomasello and Palumbo, {Vincenzo Davide} and {Lo Monte}, {Attilio Ignazio} and Antonio Bruno and {Di Trapani}, Benedetto and Simone Tomasini and Giovanni Tomasello and Mario Feo and Bernardo Molinelli and Palumbo, {Vincenzo Davide} and {Di Trapani}, Benedetto and Simone Tomasini",
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T1 - RECURRENT RETROPERITONEAL ABSCESS AFTER BILIARY TRACT SURGERY IN AN ELEDERLY PATIENT: A MINIMALLY INVASIVE NONSURGICAL APPROIACH AND ITS CONSEQUENCES: A CASE REPORT

AU - Tomasello, Giovanni

AU - Palumbo, Vincenzo Davide

AU - Lo Monte, Attilio Ignazio

AU - Bruno, Antonio

AU - Di Trapani, Benedetto

AU - Tomasini, Simone

AU - Tomasello, Giovanni

AU - Feo, Mario

AU - Molinelli, Bernardo

AU - Palumbo, Vincenzo Davide

AU - Di Trapani, Benedetto

AU - Tomasini, Simone

PY - 2019

Y1 - 2019

N2 - Introduction: Hepat 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 broncohepatic 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-years-old Caucasian woman underwent endoscopic bile stone extraction and laparoscopic colecystectomy. 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 healt, she refused any invasive approach. Conclusions: retroperitoneal abscess is an uncommon complication of biliary tract surgery and represent 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.

AB - Introduction: Hepat 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 broncohepatic 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-years-old Caucasian woman underwent endoscopic bile stone extraction and laparoscopic colecystectomy. 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 healt, she refused any invasive approach. Conclusions: retroperitoneal abscess is an uncommon complication of biliary tract surgery and represent 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.

UR - http://hdl.handle.net/10447/345276

UR - https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-019-1973-3

M3 - Article

JO - Default journal

JF - Default journal

ER -