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Retroperitoneal abscess with pylephlebitis caused by lumbar acupuncture: a case report.
BMC Surgery ( IF 1.6 ) Pub Date : 2019-10-16 , DOI: 10.1186/s12893-019-0613-6
Hayemin Lee 1 , Kiyoung Sung 1 , Jinbeom Cho 1
Affiliation  

BACKGROUND Retroperitoneal abscess (RA) is an unusual life-threatening disease that has insidious and occult presentations. Although the incidence of this disease is low, diagnosis and treatment are challenging due to its nonspecific presentation and the complex anatomy of the retroperitoneal space. Recently, we experienced one case of a RA with extensive thrombophlebitis of the portal venous system. CASE PRESENTATION An 80-year-old male presented to the emergency room with symptoms and signs of septic shock; however, the decision making for diagnosis and treatment was difficult, as no clinical and radiological evidence supported key findings regarding the origin of sepsis. Although this patient eventually recovered after surgical drainage, we suggested that more straightforward diagnostic and treatment procedures were required in this patient to avoid possible critical complications. Through a retrospective review of operative findings, patient history, and microbiology, we found that the RA in this patient was caused by lumbar acupuncture, which is usually performed for the management of chronic back pain with long needles. CONCLUSION Early surgical intervention should be considered for RA whenever the patient does not respond to broad-spectrum antibiotic treatment. Acupuncture is a possible cause of otherwise unexplained soft tissue infections, such as RA, especially in Asian countries.

中文翻译:

腰针灸致腹膜后脓肿并发性小脑炎:一例报告。

背景技术腹膜后脓肿(RA)是一种不常见的威胁生命的疾病,具有隐匿性和隐匿性表现。尽管这种疾病的发生率很低,但是由于其非特异性表现和腹膜后间隙的复杂解剖结构,诊断和治疗仍面临挑战。最近,我们经历了一例门静脉系统广泛性血栓性静脉炎的RA。病例介绍一名80岁的男性因感染性休克的症状和体征出现在急诊室。然而,由于没有临床和放射学证据支持有关败血症起源的关键发现,因此诊断和治疗的决策很困难。尽管该患者经手术引流后最终康复,我们建议该患者需要更直接的诊断和治疗程序,以避免可能的严重并发症。通过对手术结果,患者病史和微生物学的回顾性研究,我们发现该患者的RA是由腰针引起的,通常是用长针治疗慢性腰痛。结论只要患者对广谱抗生素治疗无反应,应考虑对RA进行早期外科手术干预。针灸可能是导致无法解释的软组织感染(例如RA)的可能原因,尤其是在亚洲国家。我们发现该患者的RA是由腰针引起的,通常是通过长针治疗慢性背痛。结论只要患者对广谱抗生素治疗无反应,应考虑对RA进行早期外科手术干预。针灸可能是导致无法解释的软组织感染(例如RA)的可能原因,尤其是在亚洲国家。我们发现该患者的RA是由腰针引起的,通常是通过长针治疗慢性背痛。结论只要患者对广谱抗生素治疗无反应,应考虑对RA进行早期外科手术干预。针灸可能是导致无法解释的软组织感染(例如RA)的可能原因,尤其是在亚洲国家。
更新日期:2019-10-16
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