Asian Journal of Research in Surgery

A Case of Retroperitoneal Abscess: Complicated Appendicular Perforation

Abhik Dey *

Silchar Medical College and Hospital, Assam, India.

Ranjit Chowlek Shyam

Nagaon Medical College and Hospital, Assam, India.

*Author to whom correspondence should be addressed.

---

Abstract

A 23-year-old female presented to the emergency department of Silchar medical College and Hospital on 05-04-2022 with history of severe pain abdomen and vomiting for 3 days and passage of loose stool for 1 day with 3 months amenorrhea. On examination, tenderness, guarding elicited over right lumbar region. Ultrasound examination showed debrigenous collection in the RIF region and pouch of Douglas. Pain did not decrease even after administration of analgesics. CECT Abdomen showed appendicular perforation with retroperitoneal fasciitis. Exploratory laparotomy done with appendicectomy with abscess drainage. Post-operatively, patient had surgical site infection which resolved. The patient was discharged after 4 weeks after full recovery.

Keywords: Retroperitoneal abscess, Acute appendicitis, appendicular perforation

---

---

---

References

Kloping Y, Putri RC. Atypical Presentation of Acute Appendicitis: A Case Report. The New Ropanasuri : Journal of Surgery. 2020 Dec 18;5(2):42–4.

Altemeier WA. Retroperitoneal Abscess. Archives of Surgery. 1961 Oct 1;83(4):512.

Hsieh CH, Wang YC, Yang HR, Chung PK, Jeng L Bin, Chen RJ. Retroperitoneal abscess resulting from perforated acute appendicitis: Analysis of its management and outcome. Surg Today. 2007 Sep; 37(9):762–7.

Nanavati AJ, Nagral S, Borle N. Retroperitoneal Perforation of the Appendix Presenting as a Right Thigh Abscess. Case Rep Surg. 2015;2015:1–3.

Hsieh C-H, Wang Y-C, Yang H-R, Chung P-K, Jeng L-B, Chen R-J. Extensive retroperitoneal and right thigh abscess in a patient with ruptured retrocecal appendicitis: An extremely fulminant form of a common disease. World J Gastroenterol. 2006;12(3):496.

Hsieh CH, Wang YC, Yang HR, Chung PK, Jeng LB, Chen RJ. Retroperitoneal abscess resulting from perforated acute appendicitis: analysis of its management and outcome. Surgery today. 2007 Sep;37: 762-7.

Mayumi T, Yoshida M, Tazuma S, Furukawa A, Nishii O, Shigematsu K, et al. The Practice Guidelines for Primary Care of Acute Abdomen 2015 Special Articles. Journal of General and Family Medicine. 2016;17.

Van Sonnenberg MD, E, Wittich MD, GR, Goodacre MD, BW, Casola MD, G, D’Agostino MD, HB. Percutaneous Abscess Drainage: Update. World J Surg. 2001 Mar 28;25(3):362–9.

Chan DS, Saklani A, Shah PR, Haray PN. Laparoscopic drainage of retroperitoneal abscess secondary to pyogenic sacroiliitis. The Annals of The Royal College of Surgeons of England. 2010 May;92(4): e32–4.