A case report of pneumo-retro-peritoneum: An unusual presentation of ischio-rectal abscess

Abstract

Introduction

Ano-rectal abscesses are common. They however usually do not present with abdominal symptoms. CT although useful is not routinely carried out. Finding of Pneumo-retro-peritoneum with ischio-rectal abscess is rare.

Case presentation

We present the case of a diabetic gentleman who presented with abdominal pain and distension and was found to have ischio-rectal abscess on perianal examination. Although initially suspected to have acute abdomen due to perforated viscus, CT scan revealed pneumo-retro-peritoneum which appeared to arise due to the abscess. Patient underwent incision and drainage of the abscess followed by serial debridement. He made a complete recovery.

Conclusion

Abdominal symptoms are rare in ischio-rectal abscess, but they must be kept in mind. Proper diagnosis may avoid a negative laparotomy.

Highlights

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  Ischio-rectal abscess can present with abdominal symptoms of peritonism and peritonitis.

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  Actual cause of these symptoms of peritonitis could be retro-peritoneal air which can be managed simply by incision and drainage of abscess alone.

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  Vigilance on the part of treating surgeon/physician can avoid a negative laparotomy.