A case of retroperitoneal abscess secondary to duodenal perforation

Area of Science:

• Gastroenterology
• Surgical Innovation
• Interventional Radiology

Background:

• Duodenal perforation, commonly from peptic ulcer disease, necessitates urgent surgical repair.
• Retroperitoneal abscess formation is an infrequent complication of duodenal perforation.
• Standard surgical interventions include omental pedicle or Graham patch closure for smaller perforations.

Observation:

• This case details a patient with duodenal ulcer perforation leading to a retroperitoneal abscess.
• Initial management involved interventional radiological (IR) drainage of the abscess.
• Persistent fluid collection necessitated a subsequent exploratory laparotomy.

Findings:

• The surgical procedure included a right-side hemicolectomy and Braun jejunojejunostomy.
• Pyloric exclusion and intraoperative retroperitoneal abscess drainage were performed.
• A Graham patch was utilized for the repair of the retroperitoneal duodenal perforation.

Implications:

• This case demonstrates a multimodal treatment approach for a rare complication of duodenal perforation.
• Combined interventional radiology and surgical strategies can effectively manage complex retroperitoneal abscesses.
• The findings contribute to understanding treatment options for severe duodenal perforations with abscess formation.