Recurrent retroperitoneal abscess due to perforated colonic diverticulitis in a patient with polycystic kidney disease.
Patients with autosomal dominant polycystic kidney disease (ADPKD) usually have extrarenal manifestations. We report the case of a 53-year-old man with ADPKD who presented with a retroperitoneal abscess of the left side after undergoing bilateral nephrectomy for a cyst that had repeatedly bled for 1 year. The abscess recurred despite drainage with a pig-tail catheter and antibiotic treatment. Fistulography with injection of diluted contrast medium via the pig-tail catheter showed an accumulation of contrast medium in the descending colon, which indicated a fistula between the abscess and the descending colon. A portion of the descending colon was resected, and multiple diverticulitis with 1 perforation in the resected specimen was observed. The findings support a diagnosis of retroperitoneal abscess caused by a perforated diverticulum---an extrarenal manifestation of ADPKD.
Li
Szu-Yuan
SY
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
Jiang
Jeng-Kai
JK
Chang
Yen-Hwa
YH
Wu
Te-Chang
TC
Yang
Wu-Chang
WC
Ng
Yee-Yung
YY
D000038:Abscess / Q000209:etiology*; D004239:Diverticulitis, Colonic / Q000150:complications*; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications*; D012008:Recurrence; D012187:Retroperitoneal Space