Causes and treatment of retroperitoneal phlegmon

Rare but dangerous disease that is a complication of a preceding purulent-destructive diseases that occur in the abdominal and vnebrachnyi organs, called retroperitoneal phlegmon. This disease makes the condition of the body is heavier and can lead to sepsis.

Causes of retroperitoneal phlegmon

Retroperitoneal phlegmon may occur with pancreatic necrosis or the flow of a purulent process in the kidneys, and also in cases of other similar diseases. Usually the germs are entered into the retroperitoneum hematogenous or lymphogenous way, and spaces between tissues during surgery.

But there are cases when the disease occurs much later after surgery – after a few months or years. There are even cases in which such cellulitis in people who were not operated never in my life, and undergoing inflammation.

The disease is always secondary, the diagnosis is linked with the foci of primary infection. It can be any disease or inflammation of the abdominal cavity or pelvis. In this case, possible penetration into the retroperitoneal tissue microflora capable of producing suppuration – like hematogenous and lymphokine. The most vulnerable are patients whose immune system is weakened because of the reduced protective forces of an organism in this case is not able to withstand the wide spread of germs, and therefore the delimitation of secondary foci of infection does not occur.

The most susceptible to the development of retroperitoneal phlegmon are equally both men and women age 25-42 years. The development of the educational process of suppuration occurs equally often with the two sides in areas such as retroperitoneal tissue in the lumbar, which includes the fiber, which is located above the crest of the Ilium, along the outer border of the psoas directly in the perinephric space and next to the aorta near the inferior Vena cava; iliac, including the fiber, which is located in the area of the iliac fossa, the outer border of the psoas muscle, along the iliac vessels inguinal including tissue directly above the base of the external iliac vessels.

Symptoms of retroperitoneal phlegmon is extremely nonspecific. At the beginning of the disease there is high fever up to 38 ° C, chills, and General malaise. Pain syndrome with its own characteristics manifested later. First, the localization of pulling or pulsating pain occurs in the lumbar region. Thenit has spread to other region, as if spreading over significant distances from the focus of suppuration. This happens due to the presence of a wide communication of the retroperitoneal tissue and the Central nervous system. Increased pain occurs during movement, particularly walking, trying to sit down or stand up.

The rapid spread of retroperitoneal cellulitis can lead to complications, including to the sepsis.

Treatment of retroperitoneal phlegmon

Diagnosed retroperitoneal abscess is very difficult, especially when faced with a sluggish version with the already assigned events to the erroneous treatment of diseases, such as degenerative disc disease of the spine. Easier to diagnose acute cellulitis, they discover by palpation sharply painful infiltration, the magnitude of which will depend on the location of the abscesses. If the process develops in the iliac division of the retroperitoneal tissue, the infiltration will be located in the area of the Ilium anterior to its spine along the outer border of the spinal muscles. Examining the lumbar region, you can see the roundness of the silhouette of the back, where the development of the inflammatory process. Often during palpation one can observe the voltage as the spinal and abdominal muscles. During the inspection, you can see the curvature of the lower back near the spine, with deviations will be recorded in the direction of the healthy part. But in the diagnosis of retroperitoneal phlegmon due to the fact that the abscess is deep, it is very difficult to determine changes and fluctuations.

Laboratory tests also little help in the diagnosis, because usually indicate only the presence of the inflammatory process, without specifying the location. Blood testing showed pronounced leukocytosis with the observation of the shift of leukocyte formula to the left and increased ESR.

Treatment of retroperitoneal cellulitis are beginning to pursue a conservative path, but they should not be limited in the case when there is no improvement of the patient even after two days since admission. Despite the fact that antibiotic therapy currently reaches some success in the treatment of purulent diseases and related complications, it often happens that the only effective measure that can cure retroperitoneal phlegmon is surgery. Conduct such an operation under General anesthesia. Its aim is the dissection of suppuration, drainage of the wound the purpose of the active aspiration. The postoperative treatment is characterized by a range of interventions aimed at the treatment of the main disease and prevent recurrencecellulitis. Is antibiotic therapy and bracing. Also conduct detoxication therapy by blood transfusion, protein substitutes, plasma infusion giocoso salt solutions, electrolytes, etc.