• Title/Summary/Keyword: Retroperitoneal

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Retroperitoneal Abscess Masquerading as Pyelonephritis (신우신염으로 오인된 복막뒤농양)

  • Lim, Deok-Gyo;Lee, Taek-Jin
    • Pediatric Infection and Vaccine
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    • v.28 no.3
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    • pp.168-172
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    • 2021
  • Retroperitoneal infections are rarer than intra-abdominal infections in children; however, they can lead to significant morbidity in cases of missed diagnosis. We present a case of retroperitoneal abscess caused by extended-spectrum β-lactamase-producing Escherichia coli in a 10-year-old female adolescent who failed to show clinical improvement following empirical antibiotic therapy.

MR Imaging of Primary Retroperitoneal Mucinous Cystadenocarcinoma in Pregnant Woman (임산부에서 발생한 원발성 후복막 점액낭샘암종의 자기공명영상 소견: 1예 보고)

  • Lee, Jisun;Cho, Bum Sang;Kim, Yook;Yi, Kyung Sik;Kang, Min Ho;Lee, Seung Young;Kim, Sung Jin;Park, Kil Sun
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.3
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    • pp.243-248
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    • 2013
  • Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy. To date, 51 cases have been reported, including 3 in pregnant women. Herein, we report magnetic resonance findings of a 31-year-old Korean woman (15 weeks and 3 days pregnant) with primary retroperitoneal mucinous cystadenocarcinoma. On abdominal magnetic resonance imaging (MRI), a mass was identified in the retroperitoneal area with a nodular lesion showing heterogeneous signal intensity and focal wall thickening on T1- and T2-weighted images. Exploratory laparotomy and tumor excision were performed. Histological examination revealed primary retroperitoneal mucinous cystadenocarcinoma. The patient subsequently underwent total hysterectomy, bilateral salpingo-oophorectomy, and omentectomy for metastatic mucinous cystadenocarcinoma of both ovaries 15 months after her initial surgery.

Efficacy of Postoperative Radiotherapy Using Modern Techniques in Patients with Retroperitoneal Soft Tissue Sarcoma

  • Kim, Hyun Ju;Koom, Woong Sub;Cho, Jaeho;Kim, Hyo Song;Suh, Chang-Ok
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1049-1056
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    • 2018
  • Purpose: Local recurrence is the most common cause of failure in retroperitoneal soft tissue sarcoma patients after surgical resection. Postoperative radiotherapy (PORT) is infrequently used due to its high complication risk. We investigated the efficacy of PORT using modern techniques in patients with retroperitoneal soft tissue sarcoma. Materials and Methods: Eighty patients, who underwent surgical resection for non-metastatic primary retroperitoneal soft tissue sarcoma at the Yonsei Cancer Center between 1994 and 2015, were retrospectively reviewed. Thirty-eight (47.5%) patients received PORT: three-dimensional conformal radiotherapy in 29 and intensity-modulated radiotherapy in nine patients. Local failure-free survival (LFFS), overall survival (OS), and RT-related toxicities were investigated. Results: Median follow-up was 37.1 months (range, 5.8-207.9). Treatment failure occurred in 47 (58.8%) patients including local recurrence in 33 (41.3%), distant metastasis in eight (10%), and both occurred in six (7.5%) patients. The 2-year and 5-year LFFS rates were 63.9% and 47.9%, respectively. The 2-year and 5-year OS rates were 87.5% and 71.1%. The 5-year LFFS rate was significantly higher in PORT group than in no-PORT group (74.2% vs. 24.3%, p<0.001). In multivariate analysis, PORT was the only independent prognostic factor for LFFS. However, there was no significant correlation between RT dose and LFFS. OS showed no significant difference between the two groups. Grade ${\leq}2$ acute toxicities were observed in 63% of patients, but no acute toxicity ${\geq}$ grade 3 was observed. Conclusion: PORT using modern technique markedly reduced local recurrence in retroperitoneal sarcoma patients, with low toxicity. The optimal RT technique, in terms of RT dose and target volume, should be further investigated.

Retroperitoneal Bronchogenic Cyst Located in the Presacral Space: A Case Report (전천추 부위에 생긴 후복강 기관지 낭종: 증례 보고)

  • A Yeon Kim;Seon Jeong Min;Hyunchul Kim;Jung-Ah Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.207-211
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    • 2021
  • Bronchogenic cysts are rare congenital anomalies that are most frequently found in the mediastinum along the tracheobronchial tree, especially in the posterior aspect of the superior mediastinum. Bronchogenic cysts have also been reported in intrapulmonary, intrapericardial, abdominal, and retroperitoneal locations. Herein, we report a case of a retroperitoneal bronchogenic cyst in the presacral space. The patient was diagnosed based on a post-operative histopathological examination.

Rapidly resolved IgG4-related retroperitoneal fibrosis after steroid pulse therapy

  • Jeung, Soomin;Kim, Hyosang;Seo, Yuri;Yoon, Hee-Young;Lee, Nah Kyum;Park, Shinhee;Seo, Bomi;Park, Su-Yeon;Park, Su-Kil
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.40-43
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    • 2016
  • Retroperitoneal fibrosis (RF) is a disorder characterized by the presence of a retroperitoneal mass and concurrent systemic inflammation. Some cases of RF are recognized as belonging to the spectrum of immunoglobulin G4-related disease (IgG4-RD). Glucocorticoids are highly effective for treatment of retroperitoneal fibrosis, although the optimal dose and duration of therapy have not been established. An initial dose of prednisone (40-60 mg) daily is usually administered with a tapering scheme. We report on a 55-year-old man diagnosed with IgG4-related RF and successfully treated with a 3-day course of daily 250 mg (4 mg/kg) intravenous methylprednisolone, which resulted in the prompt resolution of urinary obstruction and systemic symptoms.

Retroperitoneal Suppurative Fistula Caused by Remnant Suture Material in a Poodle Dog

  • Kim, Keunyung;Lee, Chaeyeong;Kim, Minyeon;Choi, Hyeonjong;Hong, Jeongho;Kim, Hyoyeon;Park, Hyojin;Kim, Na-hyun;Lee, Dongbin;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.38 no.6
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    • pp.285-289
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    • 2021
  • An eight-year-old, 3.4 kg, spayed female poodle dog was referred to Gyeongsang National University Animal Medical Center with obstinate bilateral retroperitoneal subcutaneous abscess. The medical history revealed ovariohysterectomy (OHE), lipoma, and mammary gland tumor excision performed two years ago. The dog presented with left retroperitoneal subcutaneous abscess discharge five months back and was treated by abscess drainage and antibiotics in a local veterinary hospital, but a relapse was reported on discontinuing antibiotics. On physical examination, the dog was febrile (40℃) and both retroperitoneal masses showed typical inflammatory reaction and purulent discharge. On serum chemistry analysis, hyperproteinemia, hyperglobulinemia, and elevated levels of C-reactive protein were observed. Cytologic examination showed degenerative neutrophils and phagocytic macrophages. Radiological examination revealed encapsulated hypoechoic subcutaneous masses in bilateral abdominal flank and the left flank mass was connected with the caudal pole of left kidney through fistula. Based on the diagnostic examination, exploratory celiotomy was recommended and left nephrectomy, and resection of bilateral masses were performed. During procedure, fistula between caudal pole of left kidney and left subcutaneous abscess was detected and suture material was identified. Resected tissue was histologically examined and diagnosed as suppurative abscess caused by the suture material. This case report describes chronic suppurative foreign body reaction including caudal pole of left kidney and bilateral retroperitoneal subcutaneous masses induced by the suture material used in OHE two years ago and the necessity of computed tomography examination to identify character of mass and extent of surgical resection.

Glue Embolization of Lymphopseudoaneurysm for Chylous Ascites after Retroperitoneal Surgery

  • Lyo Min Kwon;Saebeom Hur;Chang Wook Jeong;Hwan Jun Jae;Jin Wook Chung
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.376-383
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    • 2021
  • Objective: To assess the safety and efficacy of lymphopseudoaneurysm (LPA) glue (n-butyl cyanoacrylate [NBCA]) embolization in the management of chylous ascites after retroperitoneal surgery. Materials and Methods: A retrospective analysis from January 2014 to October 2018 was performed in six patients (4 females and 2 males; mean age, 45.3 ± 14.2 years; range, 26-61 years) who underwent LPA embolization for chylous ascites developing after retroperitoneal surgery involving the perirenal space (four donor nephrectomies, one partial nephrectomy, and one retroperitoneal lymphadenectomy). After placing a percutaneous drainage catheter into the LPA or adjacent lymphocele, embolization was performed by filling the LPA itself with a mixture of glue and Lipiodol (Guerbet). Results: Daily drainage from percutaneously placed drains exceeded 300 mL/day despite medical and surgical treatment (volume: mean, 1173 ± 1098 mL; range, 305-2800 mL). Intranodal lymphangiography was performed in four of the six patients and revealed leakage in 2 patients. Percutaneous embolization of the LPA was successful in all patients using an NBCA and Lipiodol mixture in a ratio of 1:1-1:2 (volume: mean, 4.3 ± 1.1 mL; range, 3-6 mL). Chylous ascites was resolved and the drainage catheter was removed in all patients within 4 days after the procedure (mean, 2.0 ± 1.8 days; range, 0-4 days). No procedure-related complications or recurrence of chylous ascites occurred during a mean follow-up period of 37.3 months (range, 21.1-48.4 months). Conclusion: Glue embolization of LPA has the potential to be a feasible and effective treatment method for the management of chylous ascites after retroperitoneal surgery.

Retroperitoneal Spinal Extradural Arachnoid Cyst Combined with Congenital Hemivertebrae

  • Park, Se-Hwan;Kuh, Sung-Uk;Lim, Beom Jin
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.257-260
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    • 2012
  • Spinal extradural arachnoid cysts usually cause symptoms related to spinal cord or nerve root compression. Here, we report an atypical presentation of a spinal extradural arachnoid cyst combined with congenital hemivertebra which was presented as a retroperitoneal mass that exerted mass effects to the abdominal organs. On image studies, the communication between the cystic pedicle and the spinal arachnoid space was indistinct. Based on our experience and the literature of the pathogenesis, we planned anterior approach for removal of the arachnoid cyst in order to focus on mass removal rather than ligation of the fistulous channel. In our estimation this was feasible considering radiologic findings and also essential for the symptom relief. The cyst was totally removed with the clogged 'thecal sac-side' end of the cystic pedicle. The patient was free of abdominal discomfort by one month after the surgery.

Infradiaphragmatic Retroperitoneal Pulmonary Sequestration - A Case Report - (횡격막하 후복막강에 발생한 폐격리증 - 1례 보고 -)

  • Hur, Jin;Goo, Bon-Won
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.244-247
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    • 2002
  • Pulmonary sequestration is a very rare congenital malfomation, especially when it is located in the infradiaphragmatic retroperitoneal space. The patient was a 56-year-old man with no respiratory symptom but had some postprandial epigastric discomfort for several days. Plain chest x-ray revealed mild elevation of left diaphragm and abdominal CT scan showed large cystic retroperitoneal mass with some calcification. We performed the operation through the thorachoabdominal incision and the mass was proven to be a pulmonary sequestration. Therefore, we report the case with review of literatures.

A Case of a Retroperitoneal Cystic Lymphangioma Treated by Percutaneous Catheter Drainage and Sclerotherapy (경피적 도관 배액술과 경화요법으로 치료한 후복막 낭성 림프관종 1예)

  • Kang, Hyun-Sik;Kim, Seung-Hyung;Kim, Bong-Soo;Kang, Ki-Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.86-91
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    • 2010
  • Retroperitoneal cystic lymphangiomas are benign, extremely rare tumors. Although surgical resection is the treatment of choice, sclerotherapy should be considered initially. A 9-year-old boy was admitted due do worsening abdominal pain of 4 days duration. Serial complete blood counts revealed a hemoglobin level of 12.8 g/dL on admission to 10.6 g/dL on hospital day 3. An abdominal computed tomography (CT) scan showed a large, lobulated, septated, retroperitoneal cystic mass ($10{\times}9.5{\times}5cm$) in the left anterior pararenal space with intracystic hemorrhage surrounding the inferior mesenteric vein (IMV). Because of the high operative risk, we performed a tubogram of the cystic mass, percutaneous catheter drainage (PCD), and ethanol sclerotherapy. The follow-up abdominal CT scan showed that the cystic mass had decreased in size. He is well without relapse of the retroperitoneal cystic mass for 13 months after discharge. Sclerotherapy with PCD should be considered as initial therapy for patients with retroperitoneal cystic lymphangiomas at high surgical risk.