Retroperitoneal Abscess as an Extension of Ischiorectal Abscess: A Rare Case Report

Abstract

Infections of the retroperitoneum can result from primary haematogenous spread of microbes or secondary infections originating from the retroperitoneal area or nearby organs. These abscesses can be caused by a perforated retrocaecal appendix, diverticulitis, perforated duodenal ulcers, iatrogenic gastrointestinal tract perforations, pancreatic cancer, inflammatory bowel diseases, genitourinary extravasation due to obstruction, osteomyelitis, postoperative duodenal ulcer perforations, and infections related to pelvic and puerperal conditions, as well as trauma. However, the occurrence of a retroperitoneal abscess as an extension of an ischiorectal abscess is exceedingly rare. Hereby, the authors present a case report of 27-year-old male who presented with persistent lower right quadrant abdominal pain, high-grade fever, and pus discharge from the perianal region for the last five days. He experienced difficulty passing stools and flatus for three days. Contrast-enhanced Computed Tomography (CECT) revealed a perforated appendix with fluid collection in the preperitoneal space on the right-side. Surgery revealed a significant amount of purulent discharge below the rectus muscle, extending along the right abdomen to the psoas muscle and connecting with the ischiorectal fossa. Retroperitoneal abscesses can originate from the perianal or ischiorectal region through various anatomical spaces.

Keywords

• anorectal abscess
• ischiorectal fossa
• perianal
• retroperitoneal infections
• retroperitoneal spread