[Diagnosis and treatment of retroperitoneal abscesses]

Urologe A. 2016 Jun;55(6):741-7. doi: 10.1007/s00120-016-0118-1.
[Article in German]

Abstract

Background: Retroperitoneal abscesses are rare but life threatening. Renal, perinephritic, and paranephritic abscesses are distinguished depending on their location and extent. They are mainly caused by ascending urologic infections of gram-negative bacteria.

Symptomatology: The variable symptomatology often leads to delayed diagnosis resulting in high morbidity and mortality. Typical symptoms are flank or abdominal pain, decreased appetite, weight loss, malaise, fever, and chills. Laboratory values show increased leukocytes and C‑reactive protein. Creatinine levels may also be increased.

Conclusion: If there is clinical evidence for a retroperitoneal abscess, sonography generally leads to further diagnostic via computed tomography. Small abscesses may be treated by antibiotics alone. Abscesses larger than 3 cm and those not responding to medical treatment should be percutaneously or surgically drained.

Keywords: Antibiotics; Computed tomography; Drainage; Infection, ascending; Infection, urogenital.

Publication types

  • Review

MeSH terms

  • Abdominal Abscess / diagnosis*
  • Abdominal Abscess / therapy*
  • Anti-Bacterial Agents / therapeutic use
  • Diagnosis, Differential
  • Drainage / methods
  • Evidence-Based Medicine
  • Humans
  • Retroperitoneal Space / diagnostic imaging*
  • Retroperitoneal Space / pathology
  • Retroperitoneal Space / surgery*
  • Treatment Outcome
  • Urinary Tract Infections / complications
  • Urinary Tract Infections / diagnosis*
  • Urinary Tract Infections / therapy*

Substances

  • Anti-Bacterial Agents