RAHMİ ASLAN, MESUT ÖZGÖKÇE, Recep ERYILMAZ, Mehmet Arif DURAN, Murat YILDIZHAN, KEREM TAKEN

Retroperitoneal abscesses: Origin, ethiology and percutaneous treatment

Retroperitoneal abscess is a rare clinical condition that can cause mortality if not properly treated. In our study, we aimed to report the data of retroperitoneal abscess cases which performed percutaneous drainage in the first step treatment. A retrospective study was made of 81 patients with retroperitoneal abscesses treated at our hospital from June 2010 to December 2017 for the purpose of analyzing the diagnosis and treatment of these rare infections. In each case, we analyzed patient characteristics, abscess location and origin, predisposing factors, clinical presentation, microbiology, radiographic findings, treatment, and outcome. 81 cases were identified as 11 (14%) primary and 70 (86%) as secondary. The majority (63%) of these abscesses were originated from Urinary System, while others were found to be originated from psoas, vertebral and Gastrointestinal system (GIS). Urolithiasis, previous surgery, and other Urinary system anomalies were determined to be the most common predisposing factors. Escherichia coli (E. coli) was the most commonly seen pathogen in abscess culture. In all patients, percutaneous drainage catheter was successfully placed in the abscess lodge. No serious complications occurred in patients during and after the procedure. 78/81 (96%) clinical success was achieved. In 12 months follow-ups, recurrence was seen in only 5 patients. Percutaneous abscess drainage should be preferred in the treatment of retroperitoneal abscesses as easy to perform, cost effective, low complication risk and high success rate,

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Laganà D, Carrafiello G, Mangini M, et al. Image-guided percutaneous treatment of abdominal-pelvic abscesses: a 5-year experience.[Article in English, Italian] Radiol Med 2008; 113: 999-1007.

Capitan Manjon C, Tejido Sanchez A, Piedra Lara JD, et al. Retroperitoneal abscesseseanalysis of a seriesof 66 cases. Scand J Urol Nephrol 2003; 37: 139-144.

Crepps JT, Welch JP, Orlando R. Management and outcome of Retroperitoneal abscesses. Ann Surg 1987; 205: 276-281.

Lee BE, Seol HY, Kim TK, et al. Recent clinical overview of renal and perirenal abscesses in 56 consecutivecases Korean J Intern Med 2008; 23: 140-148.

Fowler JE, Perkins T. Presentation, diagnosisand treatment of renal abscesses: 1972-1988. J Ural 1994; 151: 847-851.

Thorley JD, Jones SR, Sanford JP. Perinephric abscess. Medicine 1974; 53: 441-451.

Salvatierra O, Bucklew WB, Morrow JW. Perinephric abscess: a report of 71 cases. J Urol 1967; 98: 296-302.

Thanos L, Dailiana T, Papaioannou G, et al. Percutaneous CT-guided drainage of splenic abscess. AJR Am J Roentgenol 2002; 179: 629- 632.

Gerzof SG, Robbins AH, Birkett DH, Johnson WC, Pugatch RD, Vincent ME. Percutaneous catheter drainage of abdominal abscesses guided by ultrasound and computed tomography. AJR Am J Roentgenol 1979; 133: 1-8.

Men S, Akhan O, Koroglu M. Percutaneousdrainage of abdominal abscess. Eur J Radiol 2002; 43: 204-218.

Cinat ME, Wilson SE, Din AM. Determinants for successful percutaneous image-guided drainage of intraabdominal abscess. Arch Surg 2002; 137: 845-849.

Edelstein H. Perinephric abscesses. Modern diagnosis and treatment in 47 cases. Medicine 1988; 67:118–131

Fowler J and Perkins T. Presentation, diagnosis and treatment of renal abscesses: 1972–1988. J Urol 1994; 151: 847-851.

Winter BM, Gajda M, Grimm MO Diagnosis and treatment of retroperitoneal abscesses.Urologe A 2016; 55: 741-747.

Coelho RF, Schneider-Monteiro ED, Mesquita JL, Mazzucchi E, Marmo Lucon A, Srougi M, Renal and perinephric abscesses: analysis of 65 consecutive cases World J Surg 2007; 31: 431- 436.

Shu HH, Wah OL, Chih ML et al. Retroperitoneal abscess: 7-year experience of 29 cases in a tertiary care center in Taiwan Urological Science 2015; 26: 218-221.

Altemeier WA, Culbertsen WR, FullenWD, Shook CD. Intra-abdominalabscesses. Am J Surg 1973; 125: 70-79.

Fry DE, Garrison RN, Heitsch RC Calhoun K, Polk HC. Determinants of death in patients with intra-abdominal abscesses. Surgery 1980; 88: 517-523.

Gazelle GS, Mueller PR Abdominal abscesses. Imaging and intervention. Radiol Clin North Am 1994; 32: 913-932.

Hinsdale JG, Jaffe BM Reoperation for intraabdominal sepsis.Ann Surg 1984; 199: 31- 36.

Asai N, Ohkuni Y, Yamazaki I, Kaneko N, Aoshima M, Kawamura Y. Therapeutic impact of CT guided percutaneous catheter drainage in treatment of deep tissue abscesses.Braz J Infect Dis 2013; 17: 483-486.

Charalampopoulos A, Macheras A, Charalabopoulos A, Fotiadis C, Charalabopoulos K. Iliopsoas abscesses: diagnostic, aetiologic and therapeutic approach in five patients with a literature review.Scand J Gastroenterol 2009; 44: 594- 599.

Dinç H, Ahmetoğlu A, Baykal S, Sari A, Sayil O, Gümele HR. Image-guided percutaneous drainage of tuberculous iliopsoas and spondylodiskitic abscesses: Midterm results. Radiology 2002; 225: 353-358.

Yacoub WN, Sohn HJ, Chan S, et al. Psoas abscess rarely requires surgical intervention.Am J Surg 2008; 196: 223-227.