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A Curious Case of Recurrent Abdominal Wall Infections
An 82-year-old male was transferred for an abdominal CT scan for chronic cutaneous fistulation at the level of the right abdominal wall. Previous CT and ultrasound imaging described recurrent collections in the right abdominal wall, requiring CT guided abscess drainage. The abdominal CT scan reveale...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Ubiquity Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908932/ https://www.ncbi.nlm.nih.gov/pubmed/33665543 http://dx.doi.org/10.5334/jbsr.2387 |
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author | Djelassi, Sara Vandenbroucke, Frederik Schoneveld, Martijn |
author_facet | Djelassi, Sara Vandenbroucke, Frederik Schoneveld, Martijn |
author_sort | Djelassi, Sara |
collection | PubMed |
description | An 82-year-old male was transferred for an abdominal CT scan for chronic cutaneous fistulation at the level of the right abdominal wall. Previous CT and ultrasound imaging described recurrent collections in the right abdominal wall, requiring CT guided abscess drainage. The abdominal CT scan revealed an abscess in between the internal oblique and transversus abdominis muscle layers of the right flank, with significant fat stranding and loss of the intermuscular fat planes (Figure 1). Inside this abscess, we notice a spontaneous hyperdense nodular lesion (Hounsfield Units 130), which doesn’t enhance after contrast injection (Figure 1 arrow). Looking back at the previous CT scans we discern the presence of this hyperdense lesion, which tends to migrate over time over a small distance along the abdominal wall (Figure 2 A–D arrow). We can trace this back on the numerous previous scans, with different local tissue reactions over time. The first performed CT 8 years prior reveals a perforated calculous cholecystitis, containing multiple cholecystolithiases with the same density as our previously mentioned hyperdense lesion (Figure 3 arrow). Thus, raising the suspicion of a biliary origin of this corpus alienum. TEACHING POINT: Spilled gallstones during laparoscopy may lead to late abscess. |
format | Online Article Text |
id | pubmed-7908932 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Ubiquity Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-79089322021-03-03 A Curious Case of Recurrent Abdominal Wall Infections Djelassi, Sara Vandenbroucke, Frederik Schoneveld, Martijn J Belg Soc Radiol Images in Clinical Radiology An 82-year-old male was transferred for an abdominal CT scan for chronic cutaneous fistulation at the level of the right abdominal wall. Previous CT and ultrasound imaging described recurrent collections in the right abdominal wall, requiring CT guided abscess drainage. The abdominal CT scan revealed an abscess in between the internal oblique and transversus abdominis muscle layers of the right flank, with significant fat stranding and loss of the intermuscular fat planes (Figure 1). Inside this abscess, we notice a spontaneous hyperdense nodular lesion (Hounsfield Units 130), which doesn’t enhance after contrast injection (Figure 1 arrow). Looking back at the previous CT scans we discern the presence of this hyperdense lesion, which tends to migrate over time over a small distance along the abdominal wall (Figure 2 A–D arrow). We can trace this back on the numerous previous scans, with different local tissue reactions over time. The first performed CT 8 years prior reveals a perforated calculous cholecystitis, containing multiple cholecystolithiases with the same density as our previously mentioned hyperdense lesion (Figure 3 arrow). Thus, raising the suspicion of a biliary origin of this corpus alienum. TEACHING POINT: Spilled gallstones during laparoscopy may lead to late abscess. Ubiquity Press 2021-02-24 /pmc/articles/PMC7908932/ /pubmed/33665543 http://dx.doi.org/10.5334/jbsr.2387 Text en Copyright: © 2021 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Images in Clinical Radiology Djelassi, Sara Vandenbroucke, Frederik Schoneveld, Martijn A Curious Case of Recurrent Abdominal Wall Infections |
title | A Curious Case of Recurrent Abdominal Wall Infections |
title_full | A Curious Case of Recurrent Abdominal Wall Infections |
title_fullStr | A Curious Case of Recurrent Abdominal Wall Infections |
title_full_unstemmed | A Curious Case of Recurrent Abdominal Wall Infections |
title_short | A Curious Case of Recurrent Abdominal Wall Infections |
title_sort | curious case of recurrent abdominal wall infections |
topic | Images in Clinical Radiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908932/ https://www.ncbi.nlm.nih.gov/pubmed/33665543 http://dx.doi.org/10.5334/jbsr.2387 |
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