What Is a Retroperitoneal Abscess?

The retroperitoneal space is a potential space between the posterior peritoneum and the transverse abdominal fascia, which ranges from the diaphragm to the pelvic floor and the lateral edge of the psoas muscle and the peritoneal wall. Because the psoas muscle and the psoas muscle are located behind the transverse abdominal fascia, they also belong to the retroperitoneal area. The proportion of men and women in this disease is approximately the same, mostly between 30 and 60 years old. He often complains of irregular abdominal pain and various gastrointestinal and general symptoms such as chills, chills, fever, and sweating.

Basic Information

English name

retroperitoneal abscess

Visiting department

General Surgery

Multiple groups

30 to 60 years old

Common causes

Diseases secondary to the abdominal cavity, diseases secondary to the retroperitoneal organs, infections secondary to the spine or the twelfth rib, pelvic retroperitoneal abscesses, etc.

Common symptoms

Irregular abdominal pain, chills, chills, fever and sweating, etc.

Causes of retroperitoneal abscess

The resistance of the retroperitoneal cavity to bacterial invasion is lower than that of the peritoneum. The occurrence of retroperitoneal abscess often comes from the following five aspects:

1. Diseases secondary to the abdominal cavity

The most common are retroperitoneal appendicitis perforation, colon cancer, gastric cancer, colonic amoebic ulcer perforation, intestinal foreign body or trauma perforation, etc., which can cause infections and secondary abscesses. The pus mainly accumulates in the retroperitoneal cavity and is often a mixed infection of multiple intestinal bacteria, including E. coli, Staphylococcus aureus, Proteus, and various anaerobic bacteria.

2. Diseases secondary to retroperitoneal organs

Acute pancreatitis can occur with retroperitoneal exudate secondary enterobacterial infection. Peri-renal abscesses are often secondary to kidney diseases, such as trauma, renal dysentery, rupture of pyelemia, and pyelonephritis. Retroperitoneal suppurative lymphadenitis can also rupture and cause abscesses.

3. Infection secondary to the spine or the twelfth rib

In tuberculous spondylitis, ribitis, bacterial and actinomyelitis osteomyelitis, inflammation can spread under the fascia of the posterior abdominal wall muscles to the thighs.

4. Pelvic retroperitoneal abscess

It is often associated with infections of the rectum, bladder, prostate and female pelvic organs.

5. Hematogenous infections

Sometimes there is no such disease and the retroperitoneal infection is only secondary to bacteremia.

Clinical manifestations of retroperitoneal abscess

The proportion of men and women in this disease is approximately the same, mostly between 30 and 60 years old. He often complains of irregular abdominal pain and various gastrointestinal and general symptoms such as chills, chills, fever, and sweating. If inserted into the abdomen, nausea, vomiting, diarrhea, lower back pain and muscle tension may occur; if inserted into the psoas major sheath, patients may complain of hip pain and paresthesia due to compression of the lumbosacral nerve root; yes An abscess can form in the inguinal ligament area, which can compress the femoral nerve. The patient is in hip flexion, and the psoas muscle sign test is positive.

Examination of retroperitoneal abscess

(I) Laboratory inspection

Patients often have increased white blood cell counts and neutrophil ratios, anemia, and accelerated red blood cell sedimentation rates.

(Two) imaging examination

1.X-ray

Plain abdominal radiographs can show abnormal psoas major shadows, scoliosis, disappearance of kidney outline, or soft tissue mass shadows. Intravenous pyelography can prove kidney fixation, renal filling defect, or ureteral displacement. Chest radiographs show elevation or fixation of the diaphragm, pleural effusion, or atelectasis. Examination of barium can show visceral displacement or extravasation of barium.

2.B-ultrasound

Helps identify soft tissue abscesses, parenchymal or cystic hematomas, or emphysema.

3. Gallium nuclide scan

It is helpful for the diagnosis of sacral osteomyelitis or sacral arthritis.

4. Lymphography and CT

Can improve the detection rate of small lesions of lymph nodes.

Treatment of retroperitoneal abscess

The preferred treatment for retroperitoneal abscess is surgical drainage and appropriate antibiotic treatment. Abdominal drainage should be avoided as much as possible. Drainage of retroperitoneal abscess sometimes requires additional surgery, such as nephrectomy, intestinal resection, intestinal fistula, etc., depending on the original condition. Strengthening nutritional support treatment, improving the nutritional status of patients, helping to improve tissue healing ability and body immunity, promoting the control and limitation of infection, and speeding up tissue repair.