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Retroperitoneal Fluid Collection Following Lumbar Anterior Approach in Adult Scoliosis: Diagnosis Workup and A Case
Blanca Diez Sánchez1, Fernando González Gómez, Jorge de Ramón Suárez
1Spine Unit, Department of Orthopedic Surgery, Hospital Universitario La Paz, Madrid, Spain.
Case:
A 57-year-old woman with lumbar scoliosis underwent L4-S1 anterior lumbar interbody fusion by retroperitoneal approach. A computed tomography scan performed on postoperative day seven showed a retroperitoneal fluid collection (15 × 10 × 19 cm). After excluding haemorrhagic, urinary, infectious, lymphatic and cerebrospinal origin, it was diagnosed as a transudate. It persisted for 72 days with an output of 32 liters. It was finally resolved by open surgery using sclerosing agents. A posterior T11 pelvic fusion was subsequently performed.
Conclusion:
This is a unique case of a retroperitoneal transudate draining 32 liters requiring surgical resolution. We highlight the differential diagnosis workup.
