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Multidisciplinary approach for large retroperitoneal abscess management: A case report
INTRODUCTION AND IMPORTANCE: Retroperitoneal abscess is a rare disease that is often difficult to diagnose and require multidisciplinary management. We report a case of large retroperitoneal abscess and the usage lumbar artery perforator (LAP) for the defect closure. CASE PRESENTATION: A 52-year-old...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920875/ https://www.ncbi.nlm.nih.gov/pubmed/33652366 http://dx.doi.org/10.1016/j.ijscr.2021.105668 |
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author | Alfarissi, Fekhaza Putri, Nandita Melati Atmoko, Widi |
author_facet | Alfarissi, Fekhaza Putri, Nandita Melati Atmoko, Widi |
author_sort | Alfarissi, Fekhaza |
collection | PubMed |
description | INTRODUCTION AND IMPORTANCE: Retroperitoneal abscess is a rare disease that is often difficult to diagnose and require multidisciplinary management. We report a case of large retroperitoneal abscess and the usage lumbar artery perforator (LAP) for the defect closure. CASE PRESENTATION: A 52-year-old-women was admitted to our emergency with a chief complaint of left flank pain. Patient had history of multiple genitourinary tract procedure and diabetes mellitus type 2. We found a bulging mass on the left flank accompanied by pressure pain. A contrast CT scan revealed a large abscess on the retroperitoneal region that involved the left retroperitoneal hemiabdomen muscles. We performed multistage-treatment comprising of radical abscess debridement, followed by honey-impregnated gauze and negative pressure wound therapy for wound bed preparation. Post-debridement, the defect was closed with LAP and keystone flap. LAP flap was raised and transposed to close the defect on the caudal area. One-month follow up showed the outcome was satisfactory. CLINICAL DISCUSSION: In our case, the source of infection was thought to origin from genitourinary infection. The history of multiple urology procedures and diabetes mellitus became the main risk factors. Multistage managements were needed to eradicate the abscess. The usage of NPWT and honey-impregnated gauze was proven successful in preparing the wound bed prior to definitive closure. Lastly, the utilization LAP flap combined with keystone flap showed satisfactory outcome for defect closure. CONCLUSION: The management of patient with large retroperitoneal abscess require multidisciplinary approach including extensive debridement and well-prepared wound bed. In this report, LAP flap was proven reliable option to resurface large defect around flank area. |
format | Online Article Text |
id | pubmed-7920875 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-79208752021-03-12 Multidisciplinary approach for large retroperitoneal abscess management: A case report Alfarissi, Fekhaza Putri, Nandita Melati Atmoko, Widi Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Retroperitoneal abscess is a rare disease that is often difficult to diagnose and require multidisciplinary management. We report a case of large retroperitoneal abscess and the usage lumbar artery perforator (LAP) for the defect closure. CASE PRESENTATION: A 52-year-old-women was admitted to our emergency with a chief complaint of left flank pain. Patient had history of multiple genitourinary tract procedure and diabetes mellitus type 2. We found a bulging mass on the left flank accompanied by pressure pain. A contrast CT scan revealed a large abscess on the retroperitoneal region that involved the left retroperitoneal hemiabdomen muscles. We performed multistage-treatment comprising of radical abscess debridement, followed by honey-impregnated gauze and negative pressure wound therapy for wound bed preparation. Post-debridement, the defect was closed with LAP and keystone flap. LAP flap was raised and transposed to close the defect on the caudal area. One-month follow up showed the outcome was satisfactory. CLINICAL DISCUSSION: In our case, the source of infection was thought to origin from genitourinary infection. The history of multiple urology procedures and diabetes mellitus became the main risk factors. Multistage managements were needed to eradicate the abscess. The usage of NPWT and honey-impregnated gauze was proven successful in preparing the wound bed prior to definitive closure. Lastly, the utilization LAP flap combined with keystone flap showed satisfactory outcome for defect closure. CONCLUSION: The management of patient with large retroperitoneal abscess require multidisciplinary approach including extensive debridement and well-prepared wound bed. In this report, LAP flap was proven reliable option to resurface large defect around flank area. Elsevier 2021-02-21 /pmc/articles/PMC7920875/ /pubmed/33652366 http://dx.doi.org/10.1016/j.ijscr.2021.105668 Text en © 2021 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Alfarissi, Fekhaza Putri, Nandita Melati Atmoko, Widi Multidisciplinary approach for large retroperitoneal abscess management: A case report |
title | Multidisciplinary approach for large retroperitoneal abscess management: A case report |
title_full | Multidisciplinary approach for large retroperitoneal abscess management: A case report |
title_fullStr | Multidisciplinary approach for large retroperitoneal abscess management: A case report |
title_full_unstemmed | Multidisciplinary approach for large retroperitoneal abscess management: A case report |
title_short | Multidisciplinary approach for large retroperitoneal abscess management: A case report |
title_sort | multidisciplinary approach for large retroperitoneal abscess management: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920875/ https://www.ncbi.nlm.nih.gov/pubmed/33652366 http://dx.doi.org/10.1016/j.ijscr.2021.105668 |
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