PMC9470883_01
(A,B) Enhanced CT scans of the patient on admission and 7 days after conservative treatment (red arrows point to free abdominal gas, black arrows point to peri-duodenal and retroperitoneal exudate). (C) CT scan 7 days after percutaneous retroperitoneal tube placement for drainage (red arrows point to the placed retroperitoneal double cannula, black arrows point to periduodenal and retroperitoneal exudate). (D) shows a gastrointestinal barium study of the patient.
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F2
TB 34.90 micromol/L, CB 19.00 micromol/L, ALT 492U/L, and AST 515U/L. The CECT scan suggested (Figure 2A) suspected duodenal diverticulum perforation. One week later, a repeat CECT revealed a significant increase in fluid accumulation around the lateral descending duodenum, posterior ascending colon, and perirenal fat sac (Figure 2B). Gastrointestinal imaging showed that the diverticulum was located at the beginning of the horizontal segment of the duodenum, and contrast leakage was seen, leading to a definite diagnosis of retroperitoneal perforation of the duodenal diverticulum (Figure 2D). A review of CT scans on postoperative day 7 showed a significant reduction in retroperitoneal fluid (Figure 2C), and the patient was discharged 9 days after surgery.
Hand drawing of retroperitoneal abscess drainage through a small incision in the right lumbar region. The red arrow points to the location of the incision, approximately 3-5 cm. the dotted line is the mid-axillary line.
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F3
We then performed percutaneous retroperitoneal drainage through a small incision in the right lumbar region under basis anesthesia and local anesthesia with ultrasound localization (Figure 3).