Retroperitoneal Inflammation

Written by Brian Krans | Published on September 18, 2012
Medically Reviewed by George Krucik, MD

What Is Retroperitoneal Inflammation?

Inflammation that affects the retroperitoneal space is a serious medical condition with a high mortality rate. However, early diagnosis and treatment improves the outlook for this condition.

The retroperitoneal space is the space between the peritoneum and the posterior abdominal wall. In less complicated terms, it’s the space in your abdomen behind the abdominal lining. It houses major organs including:

  • kidneys
  • bladder
  • abdominal aorta
  • adrenal glands

Inflammation is often in response to an infection. The infection can spread all over the body and affect vital organs if left untreated. The inflammation can also cause pressure on vital organs. This pressure could cause irreversible complications.

Retroperitoneal inflammation is also known as retroperitonitis.

Causes of Retroperitoneal Inflammation

Retroperitoneal inflammation occurs when harmful bacteria come in contact with the abdominal wall. This typically occurs when the wall is punctured or ruptures due to:

  • complications with organs: a ruptured appendix, stomach ulcers, or a perforated colon can allow bacteria into your abdominal cavity
  • diverticulitis: small bulging pouches in the digestive tract can rupture and spill digestive waste into your abdomen
  • medical procedures: complications from gastrointestinal surgery, feeding tubes, contaminated equipment, or any procedure that uses catheters to draw fluid from the abdomen or intestinal organs
  • peritonitis: infection of the membrane that lines the abdominal wall and covers the organs
  • pancreatitis: problems can arise if bacteria spreads from the pancreas
  • trauma: injury or trauma can allow outside bacteria from other parts of your body to enter the retroperitoneal space

Risk Factors for Retroperitoneal Inflammation

Chronic digestive conditions, such as stomach ulcers and diverticulitis, can create problems, especially if left untreated.

Risky behavior such as playing contact sports can make a person more susceptible to traumatic injuries that puncture the abdominal wall.

Surgical procedures performed with contaminated equipment or poor hygiene can increase a person’s risk of infection and retroperitoneal inflammation.

Symptoms of Retroperitoneal Inflammation

Retroperitoneal inflammation has similar symptoms as other abdominal infections with inflammation. Symptoms include:

  • abdominal pain
  • bloating
  • constipation
  • diarrhea
  • fatigue
  • fever
  • loss of appetite
  • problems urinating
  • unexplained weight loss

Diagnosis of Retroperitoneal Inflammation

Diagnosis begins with a physical exam. Your doctor will assess your symptoms. He or she will then typically order an abdominal X-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI). These imaging tests will show the interior of your abdomen and allow your doctor to assess your condition. This will also help your doctor see if any organs are being affected by the inflammation.

Blood tests can help identify markers of inflammation in the blood and signs of anemia (low red blood cell count). These can be signs of other conditions, such as retroperitoneal fibrosis.

Your doctor may order a biopsy (surgical removal of a small amount of peritoneal tissue) to rule out other causes of the inflammation.

Treatment of Retroperitoneal Inflammation

Treatment for retroperitoneal inflammation is extremely important in preventing complications. Treatment will require a stay in the hospital.

This condition is largely treated with antibiotics or surgery.


Antibiotics can help prevent inflammation caused by infection from spreading. The type of antibiotic and the duration of the treatment depend on the extent of the inflammation.


Your doctor may need to remove severely inflamed and infected tissue to prevent further problems. The infection could spread to other organs, for example. Surgery may be necessary if it has spread. Treatment is necessary for obstructions in the ducts or blood vessels of the organs, such as the ureters that connect the kidneys and bladder, to prevent fatal complications.

Your doctor may give you immunosuppressant therapy if he or she determines that your immune system’s response is worsening your condition.

Recovery from Retroperitoneal Inflammation

The extent of the damage and how quickly treatment can be administered determine recovery from retroperitoneal inflammation.

Hospital stays may be lengthy because it is a serious condition that can have life-threatening consequences. You will remain an inpatient until hospital staff can ensure that all issues have been treated.

Serious complications can arise when inflammation affects the organs in your abdomen, such as the abdominal aorta (the large blood vessel that carries oxygenated blood to the lower half of your body).

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