Imaging findings and clinical features of atypical retroperitoneal abscess caused by duodenal perforation: a case report and review of the literature

Journal of Medical Case Reports
Xijin MaoWanfeng Fan

Abstract

A retroperitoneal abscess caused by duodenal perforation is a relatively rare disease clinically. We report the case of a patient with a local high-density shadow at the head of the retroperitoneal pancreas. A 28-year-old Chinese man presented with fever and abdominal pain after overeating and heavy drinking. On physical examination, he had mild tenderness in his upper abdomen. Laboratory examination results showed a white blood cell count of 24.06 109/L and a neutrophil absolute value of 18.81 109/L, and a computed tomography scan showed an irregular soft tissue mass with uneven enhancement of the cystic wall in the retroperitoneal space. Gastroscopy showed that there was a fistula in the anterior wall of the duodenal bulb. Endoscopic anastomosis clip system (over-the-scope clip) of the duodenal fistula was performed successfully. After the operation, nasal feeding was provided with a nutrition tube, and empiric anti-infection, acid-inhibiting, and stomach-protecting treatments were administered. Our patient's body temperature gradually returned to normal, and his abdominal pain decreased. A retroperitoneal abscess caused by duodenal perforation can be diagnosed by clinical symptoms and abdominal computed tomography imaging. T...Continue Reading

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