Retroperitoneal cavity fluid effusion disease

　　1. The causes of duodenal wall trauma include sudden deceleration of a car causing injury to the driver and perforation of the duodenal wall or diverticulum.

　　2. The causes of pancreatic juice渗入 retroperitoneal cavity include surgical injury to the pancreas or acute pancreatitis.

　　3. The causes of bile渗入 retroperitoneal cavity include surgical or accidental trauma (open or blunt) causing bile duct injury; stone compression and obstruction causing increased bile duct pressure and leading to perforation. There are also reports of spontaneous rupture of the bile duct without an obvious cause.

　　4. Lymphatic effusion is seen in diseases involving retroperitoneal lymph nodes and lymphatic vessels, or in some surgeries such as aortic aneurysm resection, renal transplantation, radical hysterectomy for uterine cancer, lymph node resection for gastric cancer, and prostate cancer surgery, etc. Retroperitoneal lymphatic effusion often selectively involves the retrorenal space.

　　5. When the urinary tract ruptures, urine (sometimes mixed with blood)渗入the peritoneal cavity behind the abdominal wall. The causes of renal pelvis and ureteral rupture include penetrating or blunt trauma, surgery, instrumental manipulation, and dystocia-induced compression and twisting injuries. Renal parenchymal infection or significant expansion of the renal pelvis greatly increases the sensitivity to rupture caused by external force. The causes of renal or renal pelvis rupture include renal tumor, renal tuberculosis, renal pelvis hydrops, calculi (compressive necrosis), and urinary tract pressure increase caused by urinary tract stones or tumors.

　　Posterior duodenal wall or diverticulum perforation, surgical injury to the pancreas or acute pancreatitis, bile duct injury or spontaneous rupture of the bile duct, aortic aneurysm, renal transplantation, radical hysterectomy for uterine cancer, radical lymph node dissection for gastric cancer, and prostate cancer. Some patients may develop complications such as pelvic abscess, interloop abscess, subdiaphragmatic abscess, iliac fossa abscess, and adhesive intestinal obstruction. If not treated promptly, death may occur due to toxic shock.

　　The disease usually only causes mild or non-specific pain, which is different from the significant pain caused by intraperitoneal infection. Abdominal tenderness and muscle tension are also mild. It is often due to reflexive diarrhea or abdominal distension caused by stimulation of the retroperitoneal nerves. Intestinal obstruction, mental disorders, systemic exhaustion, and even shock may also occur. The severity and urgency of the symptoms depend on the location, speed, nature of the exudate, and the degree of stimulation of the retroperitoneal layer.

　　If the trauma does not cause significant penetrating injury, there may be a few hours of latent period before clinical symptoms appear, followed by secondary infection.

　　Pancreatic juice渗入the peritoneal cavity behind the abdominal wall. Initially, the exudate is within the fascia, and then it spreads to the retroperitoneal space behind the kidney. Generally, it does not enter the perirenal space. When the exudate is hemorrhagic, Turner's sign and Cullen's sign may occur, with bluish discoloration of the skin on both sides of the abdomen and around the umbilicus.

　　When the urinary tract ruptures, urine (sometimes mixed with blood)渗入the peritoneal cavity behind the abdominal wall. When the lesion is in the renal pelvis and ureter, the exudate is mainly urine, while it is mainly blood when the renal parenchyma is damaged. Renal pelvis造影 shows that with the increase in pressure, the X-ray contrast agent in the renal pelvis can渗入the lymphatic vessels, veins, perirenal tissue, or perivesical tissue. Occasionally, there are reports of urinary tract rupture without obvious lesions, with urine渗入the peritoneal cavity behind the abdominal wall. Urinary tract rupture can be acute or gradually develop. There are reports that spontaneous rupture may occur several weeks or months after renal pelvis reconstruction surgery. The symptoms caused by urine leakage are very diverse, ranging from very mild to severe abdominal pain, palpable tender masses, abdominal distension, nausea and vomiting, chills, fever, exhaustion, and even shock. When the exudate is only urine, without bacterial infection and not much in quantity, it can be absorbed. If there are pathogens in the urine, it will cause diffuse inflammation of the surrounding tissues, leading to suppuration and further forming perinephric abscess or retroperitoneal abscess. There have been observations of retroperitoneal calculi formed by the precipitation of ammonium magnesium, which gradually increased in size. Chronic urinary tract leakage can lead to aseptic inflammation and fat dissolution in the perinephric space, forming pseudocysts. At this time, palpable masses can often be felt along with varying degrees of abdominal pain. Chronic urine leakage can lead to fibrosis of the ureter and perinephric area, causing urinary tract stenosis, but true retroperitoneal fibrosis will not occur.

　　The prognosis of this disease should be determined according to the severity of the disease, the causes are numerous and complex, and it is difficult to prevent. Early appropriate treatment of diseases that may cause retroperitoneal cavity effusion is the fundamental measure to prevent retroperitoneal cavity effusion. Any abdominal surgery, including abdominal puncture, should be strictly carried out under sterile conditions. Oral antibiotics before intestinal surgery can reduce the occurrence of retroperitoneal cavity effusion.

　　At the time of diagnosis, in addition to relying on clinical manifestations, auxiliary examinations are also needed. This disease has B-ultrasound, CT. It seriously affects the daily life of patients, so it should be actively prevented. It should attract the attention of clinical doctors and patients.

　　Firstly, what foods are good for retroperitoneal cavity fluid渗 disease

　　1. Provide easily digestible protein foods such as milk, eggs, fish, and soy products.

　　2. After surgical drainage, closing and repairing the leaking area, semi-liquid or semi-solid foods such as congee, green vegetable soup, and noodle soup can be eaten.

　　3. It is recommended to eat more fresh vegetables and fruits to supplement the body's required vitamins.

　　Secondly, what foods should be avoided for retroperitoneal cavity fluid渗 disease

　　Foods that are不利于 wound healing, such as hog meat, fermented bean curd, scallions, chili peppers, chives, etc., because they are easy to cause infection and hinder wound healing, should be avoided.

　　1. General supportive treatment includes high-protein, high-calorie diet. Parenteral total parenteral nutrition, such as albumin injection, can support for a period of time.

　　2. Diuretic therapy can alleviate the symptoms of abdominal distension, but excessive diuresis can lead to dehydration, hypotension, low blood sugar, and electrolyte disorder, which requires attention to adjustment.

　　3. Intraperitoneal chemotherapy selects different chemotherapy drugs according to the primary cancer, commonly used drugs include mitomycin, fluorouracil, doxorubicin, and cisplatin.

　　4. In recent years, lauric acid emulsion has been used, injected 400mg/mL after the abdominal fluid is drained, once a week, and dexamethasone 10mg is also injected at the same time, for 2 weeks of treatment.