25/04/2025
*Another case*
Case of 61 yo male
Kth left breast mass , stage 4 non resectable / chemotherapy since 2 years
1st or: Admitted (another hospital , another surgeon ) for pneumoperitoneum and surgical abdomen..
Unstable pt
Hypoalbuminemia 2.5
Immunocompromised pt
Urgent laparatomy perforated viscus ( sigmoid/ ant wall).
F***l peritonitis
Hinchey classification type 4
The surgeon decided to perform a primary repair of the perforation.
After 2 months / pt presented to the ER for diffuse abdominal distension and diffuse admominal pain and obstipation ( no flatus since 4 days ) ..
Labs wbc high
Crp high
Hg 11
Ct scan with re**al contrast was repeated : huge plevic f***l collection ( 8×8 cm )
2 another perosplenic collection with splenic flexure compression ..
Or:
Urgent laparatomy
Huge f***l collection
Hartmann
Drainage of f***l collection , abscess.
