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Case Report



PERCUTANEOUS DRAINAGE : AN EFFECTIVE AND LESS AGRESSIVE APPROACH FOR COMPLICATED DIVERTICULAR ABSCESS

Mohamadou Lamine Gueye, Jaafar Ibn Abu Talib Thiam, Abdou Niasse, Ousmane Thiam, Hamidou Deme, Mamadou Seck, Alpha Oumar Toure, Cheikh Tidiane Toure.




Abstract
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Retroperitoneal abscess is a serious complication of diverticular disease. Its management involves several options, ranging from conservative management to surgery. Elective colectomy is most often thought to be mandatory after a percutaneous drainage given the high rate of recidive. However, in patients with high risk for surgery, percutaneous drainage is often the main therapeutic alternative. We report a case of a 80-year-old woman, who was diagnosed to have a retroperitoneal abscess complicating a sigmoid diverticulitis. Ultrasound-guided percutaneous drainage allowed to drain 1500cc of pus and gas. The cytobacteriological examination was positive for: Streptococcus spp and Alkalescens dispar. The therapeutic outcomes were uneventful and despite we did not realize a colectomy because the patient was at high risk for surgery, there was no recidive after a 2-year-follow-up period. Percutaneous drainage can be a therapeutic alternative in patients with high risk for surgery in diverticular abscess of big size.

Key words: Diverticular abscess, percutaneous drainage, sigmoid diverticulitis, Hinchey II






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