Edição 2018

Paracolic intra-abdominal abscess diagnosed and treated through colonoscopy

Gonçalo Nunes, Marta Patita, Vítor Fernandes

A 68 years old woman, with no relevant medical history, was referred due to mild abdominal discomfort persisting for several months. She denied fever, weight loss, change in bowel habits and evidence of gastrointestinal bleeding. Abdominal ultrasound and CT scan revealed an irregular thickening in the sigmoid, highly suggestive of neoplasia. In total colonoscopy a large cavity was identified at 35cm from the anus, contacting with the lumen and draining purulent fluid (figures 1-3). It was suggestive of a paracolic intra-abdominal abscess. Extensive washing and aspiration were performed to achieve complete cleaning. Biopsies excluded neoplasia. The patient refused surgery and three months later she was asymptomatic.  Control endoscopy performed at this time showed the previous cavity in continuity with the lumen but without the previous purulent discharge.

Outras fotos:

Hospital Garcia de Orta, Almada