a 10-year institutional retrospective analysis of retroperitoneal abscess

Background: retroperitoneal abscess (ra) is a rare and often insidious disease, i.e., difficult to diagnose. ra could originate from different retroperitoneal or intra-abdominal organs. the disease manifests various clinical symptoms and is usually treated with a combination of antibiotics and therapeutic interventions. methods: data from a total of 25 patients who were admitted to loghman hospital in tehran city, iran with a diagnosis of ra from 2010 to 2020 were reviewed in this research. clinical findings, diagnostic tools, treatment approaches, and microbiology data were considered and analyzed.results: out of the 25 patients, the most frequent sources of ra were primary infections (36%), followed by gastrointestinal origin (20%). fifty-two percent of patients presented no underlying disease; however, diabetes mellitus was the most prevalent underlying disease in the remaining ones. fever, chills, and back or flank pain (56%) were the most common symptoms in the studied patients. besides, a high erythrocyte sedimentation rate (mean: 93.58%) was found in most of the researched patients. computed tomography (ct) scan and magnetic resonance imaging (mri) could reliably diagnose the disease with an accuracy of 100% and 92.3%, respectively. seventy-two percent of the study patients eventually underwent surgery. by taking advantage of ct scan, 24% of abscesses were drained and only 4% required medications to achieve remission. mycobacteria and klebsiella pneumonia were the most prevalent pathogens among the explored patients. the total mortality rate was equal to 12%; it occurred in cases with ra of a gastrointestinal (8%) or genitourinary (4%) origin.conclusion: there exist 3 major choices for treating abscesses, including surgery, image-guided percutaneous drainage, and medical therapy. image-guided drainage is recommended in primary infections; however, extra-peritoneal surgery is useful to treat secondary infections, especially those of a gastrointestinal source.