A PEDIATRIC CASE OF A PYOGENIC RETROPERITONEAL CYST PRESENTED WITH ACUTE ABDOMEN

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A 13-year-old girl was admitted to the hospital because of abdominal pain and a high fever of 40°C. Antibiotics administered with a diagnosis of pyonephrits were ineffective. Physical examination revealed tenderness, distention and peritoneal sign at the left lower quadrant of abdomen. The laboratory data revealed leukocytosis (15000/μl) and a high level of CRP (29.3mg/dl). Abdominal computed tomographic scan visualized a giant cystic tumor located from the left side abdomen to intrapelvic region. An emergency operation was performed with a diagnosis of pyogenic retroperitoneal cyst because the chemotherapy was unsuccessful. At laparotomy the tumor with thickened and heated wall had arisen in the retroperitoneum under the descending colon. The tumor was 28×10×16cm in dimension, including pus. Histopathological examination revealed that the cyst was lined with the transitional epithelium. Therefore, it was diagnosed as retroperitoneal cyst originated in the urinary tract genesis. This paper is the first report describing the pyogenic retroperitonal cyst including pus.
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