Teng, H.; Wu, P.-H. Perirectal Abscess with Anterior Extension to the Extraperitoneum and Space of Retzius: A Case Report. Medicina2024, 60, 293.
Teng, H.; Wu, P.-H. Perirectal Abscess with Anterior Extension to the Extraperitoneum and Space of Retzius: A Case Report. Medicina 2024, 60, 293.
Teng, H.; Wu, P.-H. Perirectal Abscess with Anterior Extension to the Extraperitoneum and Space of Retzius: A Case Report. Medicina2024, 60, 293.
Teng, H.; Wu, P.-H. Perirectal Abscess with Anterior Extension to the Extraperitoneum and Space of Retzius: A Case Report. Medicina 2024, 60, 293.
Abstract
A perirectal abscess, while typically considered benign, has the potential to invade extraperitoneal spaces, including the space of Retzius, resulting in complications with severe systemic illness. It is postulated that there is communication within adipose tissue between the pararectal spaces and the vesical extraperitoneal space anteriorly, secondary to the termination of the umbilical-vesical fascia at the reflection of the vesical peritoneum. While occurrences of perirectal abscess ex-tending to the extraperitoneal space are infrequent, a thorough understanding of the anatomical structure, physiology, and the subsequent therapeutic approach remains crucial. For assessment, a computed tomography scan with intravenous contrast is preferred for evaluation, given the probable insidious and nonspecific nature of the clinical presentation, physical exam signs, and even laboratory studies. Primary therapeutic modalities involve immediate resuscitation, intra-venous administration of broad-spectrum antibiotics, and percutaneous drainage. Surgical in-tervention may become necessary in cases where there is no prompt improvement in septic progression. Additionally, the underlying comorbidities and baseline illness could be indicative of unfavorable outcomes. If fever or sepsis is not efficiently controlled, a more comprehensive workup or intervention should be contemplated, considering the associated higher risks of complications and mortality rates.
In this study, we presented the case of a 68-year-old male with diffuse pain located in the lower abdomen. Fortunately, an immediate computed tomography scan played a pivotal role in iden-tifying a perirectal abscess with upward extension to the space of Retzius, which was subse-quently treated appropriately. Above all, this rare case presentation underscores the anatomic complexity within pelvic compartments and emphasizes the importance of maintaining high-index suspicions and analyzing overall differential diagnosis.
Keywords
perirectal abscess; extraperitoneal extension; space of Retzius
Subject
Medicine and Pharmacology, Surgery
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
