2020 Volume 53 Issue 12 Pages 960-967
A 62-year-old male presented with fever lasting for 5 days, vomiting, and diarrhea. Abdominal enhanced CT revealed intraperitoneal gas around the duodenum and abscess formation extending throughout the retroperitoneal space from the posterior of the duodenum into the pelvic. These findings led to a diagnosis of retroperitoneal abscess with duodenal ulcer penetration. Treatment with percutaneous drainage and antibiotics was used. CT-guided drainage of the abscess cavity of the right pelvic region was performed on the 3rd hospital day. Exchange of the drainage tube was needed several times because the abscess cavity was extensive, but the drainage was effective. An upper gastrointestinal series performed on the 21st hospital day showed closure of the penetration site, and oral intake was started on the same day. X-ray fluoroscopy performed on the 42nd hospital day indicated complete resolution of the abscess cavity, and the drainage tube was removed. The patient was discharged on the 45th hospital day. Conservative management for penetrating duodenal ulcer with retroperitoneal abscess formation is less invasive than surgery and may be a treatment option for patients with stable vital signs.
