A 65-year-old woman presented with a history of chronic alcoholism and polymyalgia rheumatica at the time of admission.
She presented with a 1-month history of colic pain in the left flank with poor response to analgesics, with no other associated voiding symptoms.
He also complained of pain when mobilizing the hip, especially flexion of the hip, and in the days prior to admission, pain when walking.
The examination revealed a non-painful globulose abdomen, with no masses or enlargement.
Blood and urine analytical parameters were normal except for mild leukocytosis.
Abdominal ultrasound showed a polylobulated and very heterogeneous mass of 11 x 8 cm, which seemed to originate in the left renal hilium growing into the retroperitoneum without affecting the urinary tract.
The first T.A.C. performed a retroperitoneal mass with cystic component and solid areas with fat inside, which displaced the left kidney Luba and left Psoas muscle and the square.
Bone scintigraphy was negative.
T.A.C.-guided puncture was performed, obtaining bloody fluid without cellularity.
The patient was afflicted with persistent leukocytes.
Urinocultives and hemocultives were negative.
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Since the findings of the puncture were not evident and given the increase in the abdominal perimeter of the patient, it was decided to repeat the A.C.T., which showed a decrease in the size of the extended mass x peritoneal mass until a new collection, cm.
1.
Due to the suspicion of retroperitoneal abscess and its large size open drainage was decided 1800 cc extra drainage with a purulent content.
Streptococcus pneumoniae grew in the culture of the material obtained, being negative for anaerobic bacteria and others.
In T.A.C. control performed 3 weeks after the intervention, the practice of resolution of the process was observed, showing a minimum amount of fluid in the pelvis lower.
