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Case 350.

Shimwoo Lee1, Joseph Miller1

  • 1Department of Interventional Radiology, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027.

Radiology
|May 26, 2026
PubMed
Summary
This summary is machine-generated.

A 16-year-old girl experienced persistent flank pain and swelling. Imaging revealed an abscess, which was drained but recurred, necessitating further CT imaging for diagnosis and management.

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Area of Science:

  • Medical Case Study
  • Radiology
  • Infectious Disease

Background:

  • A 16-year-old female presented with a month of escalating right lower back pain and a palpable flank mass.
  • Initial lumbar radiograph was normal; however, symptoms worsened, prompting emergency department evaluation.
  • The patient had a history of laparoscopic appendectomy for perforated appendicitis.

Purpose of the Study:

  • To present a case of recurrent flank abscess in a young female.
  • To highlight the diagnostic utility of advanced imaging in complex abdominal infections.
  • To discuss the management challenges of post-surgical abdominal abscesses.

Main Methods:

  • Clinical presentation, physical examination, and laboratory findings (leukocytosis, elevated C-reactive protein) were documented.

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  • Diagnostic imaging included ultrasound (US), contrast-enhanced magnetic resonance imaging (MRI) of the abdomen, and contrast-enhanced computed tomography (CT) scans.
  • Percutaneous drainage of the abscess was performed, followed by antibiotic therapy.

    • Main Results:

    • Initial imaging suggested an abscess, leading to percutaneous drainage and antibiotic treatment.
    • Cultures were negative, potentially due to pre-procedure antibiotic administration.
    • The patient experienced a recurrence of flank pain and purulent drainage one month after drain removal, requiring repeat CT imaging.

    Conclusions:

    • Recurrent flank abscesses can occur even after initial drainage and antibiotic therapy.
    • Advanced imaging modalities like MRI and CT are crucial for diagnosing and managing complex abdominal abscesses.
    • This case underscores the importance of thorough follow-up and reassessment in patients with persistent or recurrent symptoms post-intervention.