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经 Petit 腰三角的腹膜后胃肠道穿孔所致腹外腰椎脓肿:2 例 CT 诊断报告

Extra-abdominal lumbar abscesses caused by retroperitoneal gastrointestinal perforations through the lumbar triangle of Petit: report of two cases diagnosed by CT.

作者信息

Coulier Bruno, Gogoase Monica, Ramboux Adrien, Pierard Frederic

机构信息

Department of Diagnostic Radiology, Clinique St Luc, Rue St Luc 8, 5004 Bouge, Namur, Belgium.

出版信息

Abdom Imaging. 2012 Dec;37(6):1122-8. doi: 10.1007/s00261-012-9847-9.

Abstract

Extra-abdominal abscesses of gastrointestinal origin developing within the lumbar subcutaneous tissues are extremely rare. We report two cases of retroperitoneal bowel perforation presenting spontaneously at admission with a lumbar abscess trespassing the lumbar triangle of Petit, a classical "locus of minus resistencia" of the posterior abdominal wall. The first case was caused by perforation of a retrocecal appendicitis--being concomitantly responsible of a necrotizing fasciitis of the thigh--and in the second case perforation was caused by left colonic diverticulitis. In both cases, the full diagnosis was made with abdominal CT. The patients were threatened by a two-step surgical approach comprising a direct posterior percutaneous drainage of the abscess followed by classical laparotomy.

摘要

胃肠道源性的腹外脓肿在腰部皮下组织内形成极为罕见。我们报告两例腹膜后肠穿孔病例,入院时均以腰大肌脓肿自发出现,该脓肿穿过 Petit 腰三角,这是后腹壁的一个典型“阻力最小部位”。第一例是由盲肠后阑尾炎穿孔引起的,同时还导致了大腿坏死性筋膜炎;第二例穿孔是由左结肠憩室炎引起的。两例均通过腹部 CT 做出了全面诊断。患者面临着两步手术的风险,第一步是经皮直接对脓肿进行后路引流,第二步是进行经典的剖腹手术。

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