Retroperitoneal and horseshoe abscesses are particularly important because of the anatomic characteristics and the clinical differences between treatment approaches. There are several challenges in treating perirectal and Retroperitoneal abscess, the most important of which are partial recovery, high recurrence rates, and continence problems. A 65-yearold male patient underwent laparotomy at an external center with a diagnosis of ileus. Although no intraoperative pathology was detected, ileus persisted postoperatively, and the patient was referred to our clinic where he was diagnosed with a complicated horseshoe abscess, 9 cm in diameter and displaying Retroperitoneal extension. Perirectal abscess drainage was performed, and the patient was discharged on the 5th day after the treatment. To the best of our knowledge, there have not been any previously reported cases of ileus caused by Retroperitoneal abscess as a complication of horseshoe abscess. The case presented in this paper represents a rare complication, thereby contributing to the literature which remains to be explored.

Background: Retroperitoneal abscess (RA) is a rare and often insidious disease, i. e., difficult to diagnose. RA could originate from different Retroperitoneal or intra-abdominal organs. The disease manifests various clinical symptoms and is usually treated with a combination of antibiotics and therapeutic interventions. Methods: Data from a total of 25 patients who were admitted to Loghman Hospital in Tehran City, Iran with a diagnosis of RA from 2010 to 2020 were reviewed in this research. Clinical findings, diagnostic tools, treatment approaches, and microbiology data were considered and analyzed. Results: Out of the 25 patients, the most frequent sources of RA were primary infections (36%), followed by gastrointestinal origin (20%). Fifty-two percent of patients presented no underlying disease; however, diabetes mellitus was the most prevalent underlying disease in the remaining ones. Fever, chills, and back or flank pain (56%) were the most common symptoms in the studied patients. Besides, a high erythrocyte sedimentation rate (mean: 93. 58%) was found in most of the researched patients. Computed Tomography (CT) scan and Magnetic Resonance Imaging (MRI) could reliably diagnose the disease with an accuracy of 100% and 92. 3%, respectively. Seventy-two percent of the study patients eventually underwent surgery. By taking advantage of CT scan, 24% of abscesses were drained and only 4% required medications to achieve remission. Mycobacteria and Klebsiella pneumonia were the most prevalent pathogens among the explored patients. The total mortality rate was equal to 12%; it occurred in cases with RA of a gastrointestinal (8%) or genitourinary (4%) origin. Conclusion: There exist 3 major choices for treating abscesses, including surgery, imageguided percutaneous drainage, and medical therapy. Image-Guided drainage is recommended in primary infections; however, extra-peritoneal surgery is useful to treat secondary infections, especially those of a gastrointestinal source.

Formation of a Retroperitoneal abscess after endometriosis laparoscopy is a rare complication, but if occurs, it may cause morbidity and mortality. Hematoma at the trocar site, if not detected during surgery, may cause Retroperitoneal abscess. In this case, we have investigated and managed a specific case of Retroperitoneal abscess after endometriosis laparoscopy. A 38-year-old female patient was diagnosed with extensive endometriosis and underwent laparoscopy. Four days after surgery, she experienced swelling and pain at the suprapubic trocar site. On the 11th day after surgery, the patient was referred due to abundant purulent secretions from the suprapubic trocar site and hospitalized. In the CT scan, there was a large collection in the pelvic extraperitoneal space of the Retzius space and the interior of the bladder, spreading to the paracolic gutters and the subhepatic area. Intramuscular meropenem and vancomycin were prescribed for treatment. Drainage of the above collection was done under ultrasound guidance. Three-hundred milliliters of pus was drained and an 8 French pigtail drain was placed percutaneously in the suprapubic area. 48 hours after discharge, the patient's fever stopped. After 14 days, purulent discharge from the drain stopped and the drain was removed. It seems that the correct techniques of trocar placement along with a complete understanding of the anatomy of the anterior abdominal wall, as well as paying attention to the diagnosis of vascular damage at the site of the surgical trocar are effective in preventing hematoma at the laparoscopic port site and preventing subsequent potential complications.

Liposarcoma are one of the common soft tissue sarcomas of adulthood which are remarkable because of their frequently large size. We report a case with an extremely large well-differentiated Retroperitoneal liposarcoma that weighted 32 kilograms. The patient had relapse about one year later and two recurrent tumors were successfully excised.

A 45-year-old man was diagnosed with Retroperitoneal ganglioneuroma. The tumor was a large encapsulated mass of firm consistency with a homogeneous, solid, grayish white-cut surface, having a focally edematous appearance (Figures, Top).

Background and Objectives: Brain abscess remains a potentially fatal central nervous system (CNS) disease, especially in developing countries. Anaerobic abscess is difficult to diagnose because of cumbersome procedures associated with the isolation of anaerobes.Materials and Methods: This is a hospital-based retrospective microbiological analysis of 430 brain abscess materials (purulent aspirates and/or tissue), for anaerobic organisms, that were received between 1987-2014, by the Microbiology Laboratory in our Institute.Results: Culture showed growth of bacteria 116.430 (27%) of the cases of which anaerobes were isolated in 48.116 (41.1%) of the cases. Peptostreptococcus (51.4%), was the predominant organism isolated in four cases followed by Bacteroides and Peptococcus species.Conclusion: Early diagnosis and detection of these organisms would help in the appropriate management of these patients.