Retroperitoneal Fluid Collection Following Lumbar Anterior Approach in Adult Scoliosis

Case: A 57-year-old woman with lumbar scoliosis underwent L4-S1 anterior lumbar interbody fusion by retroperitoneal approach. A computed tomography scan performed on postoperative day seven showed a retroperitoneal fluid collection (15 × 10 × 19 cm). After excluding haemorrhagic, urinary, infectious, lymphatic and cerebrospinal origin, it was diagnosed as a transudate. It persisted for 72 days with an output of 32 liters. It was finally resolved by open surgery using sclerosing agents. A posterior T11 pelvic fusion was subsequently performed. Conclusion: This is a unique case of a retroperitoneal transudate draining 32 liters requiring surgical resolution. We highlight the differential diagnosis workup.