Abscessed retroperitoneal hematoma as a late complication of adrenalectomy: a case report.

Abstract

Retroperitoneal hematoma is an uncommon complication

following adrenalectomy; however, its progression to abscess

represents a potentially life-threatening condition associated

with high morbidity and mortality when diagnosis and

treatment are delayed. Clinical presentation is often

nonspecific, including fever without an identifiable source,

abdominal or flank pain, and systemic inflammatory

response, which may delay early recognition. Predisposing

factors include recent surgical procedures, persistent

undrained collections, and immunocompromised states,

particularly in oncologic patients. Diagnosis relies on clinical

suspicion supported by imaging studies, with computed

tomography being the modality of choice to identify

retroperitoneal collections and signs of infection. Treatment

depends on the patient’s clinical condition and characteristics

of the collection, requiring broad-spectrum antibiotic therapy

and, in most cases, percutaneous or surgical drainage. We

present the case of a 76-year-old male with a history of right

nephrectomy for metastatic clear cell renal carcinoma and

adrenalectomy,

who

developed

left

retroperitoneal

collections suggestive of abscess, requiring specialized

hospital management.