Abstract
Retroperitoneal abscess caused by perforated duodenal ulcer is a comparatively rare disease and we have great difficulties in treatment. Recently we have experienced a case of the disease treated by transduodenal abscess drainage that permitted to avoid surgery. The case involved a 64-year-old man who presented to our hospital because of right-sided abdominal pain. Echography and CT scan of the abdomen revealed a 70-mm abscess in the right retroperitoneal space. Esophagogastroduodenoscopy demonstrated an ulcer and pus discharge into the duodenum at the posterior wall of the descending part of duodenum. Retroperitoneal abscess caused by perforation of duodenal ulcer was diagnosed and conservative therapy was started. On the 7th hospital day, however, he developed right hydronephrosis due to spread of inflammation. We thus performed endoscopic abscess drainage using an endoscopic nasobiliary drainage tube (ENBDT) that resulted in improvement of subjective and objective findings, shrinkage of the abscess cavity, and improvement of hydronephrosis. The ENBDT was removed on the 16th hospital day and he was discharged from our hospital on the 21st hospital day. He has been doing well without recurrence as of 10 months after discharge. Our procedure described here that can provide less invasive and efficient abscess drainage is useful.
