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[Retroperitoneal perforation of duodenal ulcer responsible for abscess]
Abstract:
The authors report a case of retroperitoneal perforation of a duodenal ulcer. This is a rare condition which is exceptionally responsible for abscess formation. If often has a poor prognosis. In the present case, the abscess was infrahepatic. The diagnosis of the origin of the abscess was established by radiological opacification via percutaneous puncture. Surgical drainage and irrigation performed via an extraperitoneal approach centered over the cavity, combined with triple-agent antibiotic therapy (penicillin, gentamicin, metronidazole) ensured collapse followed by sterilisation of the abscess cavity. The ulcer was cured by medical treatment. This case differs from the published case in terms of the diagnostic procedures classically used (upper gastrointestinal endoscopy and small bowel series), the infrahepatic site of the abscess and the extraperitoneal surgical treatment which avoided dissemination to the peritoneal cavity.
Insights
Retroperitoneal perforation of a duodenal ulcer, a rare cause of abscess, was successfully treated. This case highlights an alternative diagnostic and surgical approach for infrahepatic abscesses.
Area of Science:
- Gastroenterology
- Surgical Case Reports
- Infectious Diseases
Background:
- Retroperitoneal perforation of a duodenal ulcer is a rare complication.
- Abscess formation secondary to this condition is exceptionally uncommon and often carries a poor prognosis.
Observation:
- A case presented with an infrahepatic abscess originating from a retroperitoneal duodenal ulcer perforation.
- Diagnosis was confirmed using radiological opacification via percutaneous puncture.
Findings:
- Successful management involved extraperitoneal surgical drainage and irrigation.
- Triple-agent antibiotic therapy (penicillin, gentamicin, metronidazole) led to abscess cavity sterilization.
- The duodenal ulcer resolved with medical management.
Implications:
- This case demonstrates an alternative diagnostic strategy, avoiding traditional endoscopy and small bowel series.
- An extraperitoneal surgical approach prevented peritoneal cavity dissemination.
- The findings suggest a viable alternative treatment for infrahepatic abscesses secondary to duodenal perforation.