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Extraperitoneal abscess originating from an ischorectal abscess

Eman Hamza1, Mirza Faraz Saeed1, Amro Salem1

  • 1Department of General Surgery, King Hamad University Hospital, Busaiteen, Bahrain.

BMJ Case Reports
|March 24, 2017
PubMed

Insights

Persistent sepsis despite ischorectal abscess drainage indicates potential ascending infection. Further investigation is crucial for patients with systemic inflammatory response syndrome, even after local treatment.

Area of Science:

  • Surgical infection management
  • Abdominal surgery complications
  • Sepsis treatment

Background:

  • Ischorectal abscesses can lead to severe infections.
  • Sepsis requires prompt and effective treatment.
  • Systemic inflammatory response syndrome (SIRS) indicates a severe inflammatory state.

Observation:

  • A patient presented with ongoing sepsis despite incision and drainage for an ischorectal abscess.
  • An ascending infection was identified, spreading to the extraperitoneal space of the abdominal cavity.
  • Multiple drainage procedures and a lower midline incision were necessary for deep-seated abscesses.

Findings:

  • Vacuum-assisted closure and antibiotics were used for postoperative wound management.
  • The patient demonstrated clinical improvement and was discharged.
  • The case highlights a complex infectious process extending beyond the initial abscess site.

Implications:

  • Emphasizes the need for thorough investigation in cases of persistent SIRS post-abscess treatment.
  • Suggests that ascending infections require aggressive and multi-stage surgical intervention.
  • Underscores the importance of considering deeper or contiguous spread of infection in abdominal cases.

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