Extraabdominal lumbar abscess rupture through the lumbar triangle of Petit with surgical emphysema: A rare presentation of retroperitoneal caecal perforation.

Dr. Mohan Lal; Dr. Chetan Sharma

Volume : VI, Issue : V, May - 2017

Extraabdominal lumbar abscess rupture through the lumbar triangle of Petit with surgical emphysema: A rare presentation of retroperitoneal caecal perforation.

Dr. Mohan Lal, Dr. Chetan Sharma

Abstract :

A retroperitoneal gut perforation presenting with an extra–abdominal lumbar abscess with surgical emphysema secondary to retroperitoneal abscess rupture through the lumbar triangle of Petit is rarely reported. We report a case of retroperitoneal caecal perforation presenting as an extra–abdominal lumbar abscess, with surgical emphysema, trespassing the lumbar triangle of Petit diagnosed definitively by computerized tomography (CT) scan and managed by surgery in two stages. In the first stage, drainage of the retroperitoneal abscess, incision and drainage of extra–abdominal lumbar abscess, closure of perforation and end–ileostomy was done. But there was continuous mucous discharge from incision and drainage site even 4 months postoperatively due to an entero–cutaneous fistula, confirmed by a fistulogram and distal colonic patency confirmed by a colonoscopy. In the second stage, end to side ileo–ascending colon resection anastomosis was done. Patient recovered well. Biopsy showed no malignancy or tuberculosis. Summary: Extra–abdominal lumbar abscesses with surgical emphysema of caecal origin with abscess rupture through lumbar triangle of Petit are extremely rare emphasizing such abscess as possible indicator of gastrointestinal pathology and crucial role of CT scan in diagnosis and management.