The frequent difficulty in recognizing the presence of retroperitoneal abscesses and their lethal potentiality give this entity particular clinical importance. The abscesses usually are chronic by the time the patient seeks medical aid or by the time the diagnosis is made. The etiology, diagnosis, and surgical approach to these abscesses in 18 patients are described by Janke and Block in the March issue of the Archives of Surgery.1
Symptoms and signs may be poorly localized and predominantly systemic, so that efforts are diverted to the search for a systemic disease. Referral of pain to the back, lower extremities, or abdomen further diverts attention away from the pelvis. It is even possible for a surgeon exploring the abdomen to fail to recognize the abscess. Unless the abscess is adequately drained, the patient's condition slowly deteriorates, and the outcome may be fatal.
Of the retroperitoneal pelvic abscesses, those located high in