2021 Volume 41 Issue 4 Pages 255-259
A 75-year-old male patient with a past history of surgery for gastric cancer presented with a recurrent tumor after nephrectomy for left renal cell carcinoma. Systemic chemotherapy was withheld because of the generalized malaise and decreased ADL. The patient complained of right-sided abdominal pain during palliative care, with a decrease of the urine output three days after appearance of the pain. A plain abdominal CT revealed massive fluid accumulation without air in the right anterior pararenal space. We considered the diagnosis of a retroperitoneal abscess caused by perforation of an ascending colon diverticulum, and performed ileostomy. No perforation was identified during surgery. From the first postoperative day, bile leakage was confirmed from the drainage tube in the foramen of Winslow. Endoscopic retrograde cholangiopancreatography confirmed leakage of the contrast agent from the gallbladder fundus, and cholecystectomy was performed. We report a case of retroperitoneal abscess caused by perforation of the gallbladder, which was difficult to diagnose.
