PMC6176850_01
Retroperitoneal abscess and drainage.. A: CT scans showed wide range of retroperitoneal abscess formation.. B: Ultrasound-guided percutaneous abdominal drainage was performed for 3 areas of retroperitoneal abscesses.
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On day 30, CT scans showed wide range of retroperitoneal abscess formation (Fig. 1A). The first catheter was inserted in the abscess on the front of the pancreas, the second was inserted in the abscess around the splenic flexure of the left colon, and the third was inserted in the abscess around the descending colon (Fig. 1B).
Findings during surgery.. A: Retroperitoneal abscess was approached using percutaneous drainage catheter.. B: Infected necrotic tissues were removed under direct vision.. C: After the necrotic substances were removed, leakage of feces from the retroperitoneal perforated site of the colon was observed (arrow).
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Then, a 12-mm port was inserted in that hole (Fig. 2A). The abscess cavity was fully observed using the scope inserted through the port, and infected necrotic tissues were removed through the open window of the tenth intercostal space (Fig. 2B). After the necrotic substances were removed, leakage of feces from the retroperitoneal perforated site of the colon was observed (Fig. 2C). After washing with 10 L of saline solution, three silicone drains (10-mm) were placed in the washed cavities; two drains were placed in the left side cavity (dorsal side of the perforated colon and the descending colon) and one drain was placed in the middle cavity on the front of the pancreas (Fig. 2D).
Course of treatment for the abscesses.. The abscess cavities gradually contracted and disappeared.
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On postoperative day 27, fluoroscopic imaging showed disappearance of the abscess cavity (Fig. 3).