マレコカテーテルを用いた経皮的ドレナージにより治療しえた多房性後腹膜膿瘍の1例

Abstract

Percutaneous catheter drainage offers an attractive alternative to open surgical drainage as the first choice in the treatment of retroperitoneal abscess. However, multiloculated abscess is difficult to drain percutaneously. We report a case of multiloculated retroperitoneal abscess successfully treated by percutaneous drainage with a Malecot catheter. A 47-year-old woman complained of fever and left flank pain. The peripheral while blood cell count was 16, 800/mm3 and the blood sugar was 369 mg/dl. The computer tomographic (CT) scan showed a large multiloculated mass in the left retroperitoneum. An aspiration needle was inserted into the perinephric mass under ultrasonographic guidance. The definitive diagnosis of abscess was made by aspiration of purulent fluid. A 20 Fr. Malecot catheter was passed over the guide wire under fluoroscopic guidance. Two hundred ml of pus was smoothly aspirated. Streptococcus agalactiae was isolated from the aspirate. Antibiotics and insulin were started. The catheter was retained for 49 days until ultrasonography revealed disappearance of the abscess. One year later, she had no symptoms of recurrence.