Retroperitoneal infection and abscess
Introduction
Introduction to retroperitoneal infection and abscess Retroperitoneal infection and Abscessr are rare. Common pathogens are Escherichia coli, Staphylococcus aureus, Proteus vulgaris, Aerobacteria and Streptococcus. Occasionally, anaerobic bacteria, Mycobacterium tuberculosis, Brucella, actinomycetes and amoeba, etc., the extraperitoneal space is less responsive to bacterial infections, the examination is not easy to find, and the diagnosis is difficult. basic knowledge The proportion of sickness: 0.2% Susceptible people: no special people Mode of infection: non-infectious Complications: bacteremia, kidney abscess
Cause
Retroperitoneal infection and cause of abscess
Infection or abscess is usually confined to a certain primary site, but may spread to the contralateral side or from one gap to the other. In a few cases, it may spread along the fascia plane or through the membrane to the distant area, such as the deep pelvis subperitoneal; The mesenteric root; the femoral, hip, anterior abdominal wall, dorsal and flank subcutaneous tissue; underarm, mediastinum and thoracic cavity; even a diffuse posterior peritoneal infection, causing cellulitis and necrosis.
Prevention
Retroperitoneal infection and abscess prevention
The extraperitoneal space is less responsive to bacterial infections, the examination is difficult to find, and the diagnosis is difficult. The disease is often misdiagnosed.
Complication
Retroperitoneal infection and abscess complications Complications, bacteremia, renal abscess
Diffuse posterior peritoneal infection, cellulitis, renal abscess, intra-abdominal organs, retroperitoneal organs, infection of the spine or twelfth rib, pelvic retroperitoneal abscess, and bacteremia.
Symptom
Retroperitoneal infection and abscess symptoms Common symptoms After nausea, peritoneal fibrosis, chills, subcutaneous emphysema, abdominal pain, swelling, night sweats
The main symptoms are fever, chills, night sweats, pain on both sides of the abdomen or lower back pain. Others have nausea and vomiting, anorexia, weight loss and systemic failure. Some patients have few other symptoms except systemic failure. Fever (38 ~ 39 ° C), tachycardia and majority of the abdomen (28%) have limited tender tenderness, some (38%) can touch the tender mass (sometimes need to be rectal or pelvic examination to reach) Generally, there is no abdominal muscle rigidity, sometimes there is tenderness in the rib vertebral body area, swelling of the flank, swelling of the scrotum and scoliosis, bulging of the ridge angle of the perirenal abscess, tenderness, and tendon of the waist; At the time, there are scoliosis and ipsilateral lesions, hip flexion and internal rotation, and increased white blood cells. In severe cases, there may be poisonous granules and anemia. Uncommon manifestations include sinus, subcutaneous emphysema, abscess rupture into the abdominal cavity, and small intestine. , colon, vagina, pleura, mediastinum, bronchi, pericardium or blood vessels, and corresponding performance.
Examine
Examination of retroperitoneal infection and abscess
1.B type ultrasound examination
It can detect the darkness of the liquid dark area in a certain area behind the retroperitoneum, and can determine its size, location, easy operation, repeated examination, high diagnostic value, and is the preferred method of examination.
2.X line
X-ray abdominal plain film and lateral radiographs were observed on both sides of the peritoneal fat line, both sides of the psoas muscle shadow and the spine, etc., can be found soft tissue mass, kidney contour clear, waist muscle shape changes.
3. CT and magnetic resonance (MRI)
With a higher diagnostic rate, CT can provide an accurate position of the abscess half showing the relationship between the surrounding organs.
4. Puncture pus
Puncture can be performed by fine needle aspiration under CT or B-mode ultrasound, pathological, bacteriological and biochemical examination of aspirate, and contrast agent can be injected to measure the size of abscess and tube drainage at the same time. Diagnosis and treatment effects.
Diagnosis
Diagnosis of retroperitoneal infection and abscess
diagnosis
The disease is often misdiagnosed, many patients can be diagnosed after autopsy, should be based on abdominal pain, low back pain with cold, fever and scoliosis and other local signs for diagnosis, laboratory tests can find the total number of white blood cells increased, classified neutral Granulocyte enlargement, urine test is mostly normal, there may be pyuria and proteinuria when there is abscess around the kidney, blood culture sometimes visible pathogenic bacteria, B-mode ultrasound, CT and abdominal X-ray examination are helpful for diagnosis.
Retroperitoneal tumor, retroperitoneal fluid infiltration, retroperitoneal space bleeding.
