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Endoscopic ultrasound-guided transduodenal drainage of idiopathic retroperitoneal abscess in an immunocompromised patient: A case report.

Abstract Idiopathic retroperitoneal abscesses are insidious, occult illnesses with high mortality if inadequately drained. Endoscopic ultrasound-guided drainage is an alternative to percutaneous or surgical drainage, it is not widely performed for retroperitoneal abscesses other than peripancreatic fluid collection.
PMID
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Authors

Mayor MeshTerms

Endosonography

Immunocompromised Host

Keywords
Journal Title medicine
Publication Year Start




PMID- 29390314
OWN - NLM
STAT- MEDLINE
DCOM- 20180213
LR  - 20180213
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 50
DP  - 2017 Dec
TI  - Endoscopic ultrasound-guided transduodenal drainage of idiopathic retroperitoneal
      abscess in an immunocompromised patient: A case report.
PG  - e9132
LID - 10.1097/MD.0000000000009132 [doi]
AB  - RATIONALE: Idiopathic retroperitoneal abscesses are insidious, occult illnesses
      with high mortality if inadequately drained. Endoscopic ultrasound-guided
      drainage is an alternative to percutaneous or surgical drainage, it is not widely
      performed for retroperitoneal abscesses other than peripancreatic fluid
      collection. PATIENT CONCERNS: We present a 76-year-old Japanese woman with
      abdominal pain, high fever, and a history of rheumatism on treatment with
      immunosuppressants. DIAGNOSES: The patient was diagnosed with idiopathic
      retroperitoneal abscess based on results obtained from her clinical course and
      findings on computed tomography. INTERVENTIONS: We performed Endoscopic
      ultrasound-guided drainage. After we performed needle puncture via the descending
      portion of the duodenum, the fistula was expanded using a dilator, and a
      double-pigtail stent and endoscopic nasobiliary drainage tube were inserted.
      OUTCOMES: The patient was kept nil by mouth, together with intravenous antibiotic
      therapy, and repeated washing of the abscess cavity with saline was performed.
      After that, we confirmed disappearance of the cavity, and, after removing the
      tubes, commenced oral feeding. We were able to avoid surgery in this
      immunosuppressed patient. LESSONS: Endoscopic ultrasound (EUS)-guided abscess
      drainage can be overall considered a safe and useful procedure. We also propose
      the double-stent method, with both internal and external stents, for the
      treatment of idiopathic retroperitoneal abscesses.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Sagami, Ryota
AU  - Sagami R
AD  - Department of Gastroenterology, Oita San-ai Medical Center, Oita city.
FAU - Tsuji, Hiroaki
AU  - Tsuji H
AD  - Department of Gastroenterology, Oita San-ai Medical Center, Oita city.
FAU - Nishikiori, Hidefumi
AU  - Nishikiori H
AD  - Department of Gastroenterology, Oita San-ai Medical Center, Oita city.
FAU - Murakami, Kazunari
AU  - Murakami K
AD  - Department of Gastroenterology, Faculty of Medicine, Oita University, Yuhu city, 
      Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Abdominal Abscess/*diagnostic imaging/*surgery
MH  - Aged
MH  - Drainage
MH  - *Endosonography
MH  - Female
MH  - Humans
MH  - *Immunocompromised Host
MH  - Peritoneal Diseases/*diagnostic imaging/*surgery
EDAT- 2018/02/03 06:00
MHDA- 2018/02/14 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/14 06:00 [medline]
AID - 10.1097/MD.0000000000009132 [doi]
AID - 00005792-201712150-00064 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(50):e9132. doi: 10.1097/MD.0000000000009132.