Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2023; 11(3): 645-654
Published online Jan 26, 2023. doi: 10.12998/wjcc.v11.i3.645
Acute diffuse peritonitis secondary to a seminal vesicle abscess: A case report
Kun Li, Nan-Bin Liu, Jiang-Xi Liu, Quan-Ning Chen, Bao-Min Shi
Kun Li, Nan-Bin Liu, Jiang-Xi Liu, Quan-Ning Chen, Bao-Min Shi, Department of General Surgery, Tongji Hospital of Tongji University, Shanghai 200065, China
Nan-Bin Liu, National and Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710000, Shaanxi Province, China
Author contributions: Shi BM and Chen QN contributed to the conception and design of the study and performed the operation on the patient; Li K and Liu NB collected the data, performed the data analysis, and wrote the initial draft of the manuscript; Liu JX participated in the clinical management and follow-up of the patient, and analyzed and interpreted the data; all authors contributed to drafting and revising the manuscript and approved the submitted version.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bao-Min Shi, Doctor, MD, PhD, Chief Doctor, Professor, Surgeon, Department of General Surgery, Tongji Hospital of Tongji University, No. 389 Xincun Road, Putuo District, Shanghai 200065, China. tjshibaomin@tongji.edu.cn
Received: September 26, 2022
Peer-review started: September 26, 2022
First decision: November 11, 2022
Revised: November 18, 2022
Accepted: January 3, 2023
Article in press: January 3, 2023
Published online: January 26, 2023
Abstract
BACKGROUND

Seminal vesicle abscess (SVA) is the manifestation of a relatively rare urinary system infection. In response to urinary system inflammation, an abscess forms in special locations. However, acute diffuse peritonitis (ADP) induced by SVA is unusual.

CASE SUMMARY

We report a case of a left SVA in a male patient complicated with pelvic abscess, ADP, multiple organ dysfunction syndrome, infectious shock, bacteremia, and acute appendiceal extraserous suppurative inflammation as a result of a long-term indwelling urinary catheter. The patient received a course of morinidazole + cefminol antibiotics but showed no obvious relief, so the perineal SVA underwent puncture drainage and abdominal abscess drainage + appendectomy was performed. The operations were successful. After the operation, anti-infection, anti-shock, and nutritional support treatments were continued and various laboratory indicators were regularly reviewed. The patient was discharged from the hospital after recovery. This disease is a challenge for the clinician because of the unusual spreading path of the abscess. Moreover, appropriate intervention and adequate drainage of abdominal and pelvic lesions are necessary, especially when the primary focus cannot be determined.

CONCLUSION

The etiology of ADP varies, but acute peritonitis secondary to SVA is very rare. In this patient, the left SVA not only affected the adjacent prostate and bladder but also spread retrogradely through the vas deferens, forming a pelvic abscess in the loose tissues of the extraperitoneal fascia layer. Inflammation involving the peritoneal layer led to ascites and pus accumulation in the abdominal cavity, and appendix involvement led to extraserous suppurative inflammation. In clinical practice, surgeons need to consider the results of various laboratory tests and imaging examinations to make comprehensive judgments involving the diagnosis and treatment plan.

Keywords: Seminal vesicle abscess, Acute diffuse peritonitis, Acute appendicitis, Multiple organ dysfunction syndrome, Case report

Core Tip: Seminal vesicle abscess (SVA) is a relatively rare urinary system infection, and acute diffuse peritonitis (ADP) induced by SVA is unusual. We report a male patient who had a left SVA induced by a long-term indwelling urinary catheter, and this condition was complicated with pelvic abscess, ADP, multiple organ dysfunction syndrome, infectious shock, bacteremia, and acute appendiceal extraserous suppurative inflammation. With no obvious relief by conservative treatment, puncture drainage of the perineal SVA and abdominal abscess drainage + appendectomy was performed. In this case, the left SVA not only affected the adjacent prostate and bladder but also spread retrogradely through the vas deferens, forming a pelvic abscess in the loose tissues of the extraperitoneal fascia layer. Inflammation involving the peritoneal layer led to ascites and pus accumulation in the abdominal cavity, and appendix involvement led to extraserous suppurative inflammation.