Coulier Bruno, Gogoase Monica, Ramboux Adrien, Pierard Frederic
Department of Diagnostic Radiology, Clinique St Luc, Rue St Luc 8, 5004 Bouge, Namur, Belgium.
Abdom Imaging. 2012 Dec;37(6):1122-8. doi: 10.1007/s00261-012-9847-9.
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.
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。