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Extensive retroperitoneal multiloculated abscesses after open cholecystectomy associated with bile leak: a case
Yuting Huang1, Zarah Haleem2, Harsh Patel1
1University of Maryland Medical Center Midtown Campus, Baltimore, Maryland, United States.
Abstract:
Retroperitoneal abscesses are rare and life-threatening. The incidence of abscesses after open cholecystectomies is <1% disregarding location. 11 cases reporting post-cholecystectomy retroperitoneal abscesses were archived on PubMed, 7 associated with gallstone retaining or spillage. Hereby, we present a case of extensive retroperitoneal multiloculated abscesses after open cholecystectomy complicated with bile leak, while no gallstone was noted. Early evaluation for retroperitoneal abscesses is critical if the patient does not clinically improve after cholecystectomy. Early treatment with drainage of the abscesses, antibiotics, and endoscopic retrograde cholangiopancreatography intervention to achieve source control can greatly improve the clinical outcome.
Insights
Retroperitoneal abscesses are rare complications after open cholecystectomy. Prompt diagnosis and treatment, including drainage and antibiotics, are crucial for improving patient outcomes.
Area of Science:
- Gastroenterology
- Surgical Complications
Background:
- Retroperitoneal abscesses are uncommon but severe complications following surgical procedures.
- The incidence of post-cholecystectomy abscesses is less than 1%, with most cases linked to gallstones.
Observation:
- This report details a rare case of extensive retroperitoneal multiloculated abscesses after an open cholecystectomy.
- The patient presented with a bile leak, but no gallstones were identified as a cause.
Findings:
- The study reviewed 11 PubMed cases of post-cholecystectomy retroperitoneal abscesses, with 7 involving gallstone issues.
- This case highlights a retroperitoneal abscess without gallstones, complicated by bile leak.
Implications:
- Early clinical evaluation is vital for patients not improving post-cholecystectomy, especially with suspected retroperitoneal abscess.
- Integrated treatment involving abscess drainage, antibiotics, and endoscopic retrograde cholangiopancreatography (ERCP) for source control significantly enhances clinical outcomes.
