A CASE OF RETROPERITONEAL ABSCESS DUE TO ORAL PERFORATION OF A CANCER OF THE TRANSVERSE COLON

A 78-year-old man was admitted to the hospital because of hypogastric pain. Abdominal X-ray film and computed tomography revealed retroperitoneal gas. Retroperitoneal perforation of the ascending colon was suspected, and an emergency operation was performed 3 hours after the onset of symptoms. No gross fecal soiling of the peritoneal cavity could be detected, since an abscess dur to the oral perforation of a cancer of the transverse colon was covered by the retroperitoneal adipose tissue. Abscess drainage with right hemicolectomy was performed. So far 22 cases of retroperitoneal perforation of the ascending colon have been reported, and five out of six patients reported in 1990's were successfully saved. The prognosis of retroperitoneal abscess due to colonic perforation is better than that of colonic perforation into the free peritoneal cavity, so without septic shock, active curative treatment should be performed.