Abstract
A 58-year-old man with non-insulin dependent diabetes mellitus (NIDDM), in whom diabetes mellitus was detected at age 45 but was not regularly treated, complained of mild fever, general fatigue and appetite loss. Paralytic ileus was suspected on the basis of laboratory data, the clinical findings of dehydration and abdominal swelling and the findings of gas in the small and large intestine on abdominal x-ray film. After admission, computed tomography showed a large amount of gas in the abdomen and an abscess with niveau behind the right kidney. So the patient was diagnosed as having a retroperitoneal abscess. After correction of blood glucose levels by insulin administration, treatment of the dehydration and antibiotic therapy, the abscess was surgically drained. Cultures of the drained pus were positive for Klebsiella pneumomiae. The patient had a fever again 8 weeks after his admission. The abscess was reopened and drained and the patient was doing well and had not had any recurrence of symptoms. Retroperitoneal abscess is a comparatively rare disease. In Japan, 74 cases of retroperitoneal abscess have been reported in the last 5 years. Twenty-two of the cases had diabetes mellitus. In 11 of these cases, diabetes mellitus was concerned in their onset.
