been described for kidney resection, lymphadenectomy, and adrenal gland resection in animal models.3,4 A hybrid transaginal retroperitoneoscopic nephrectomy in a human was ecently reported.5 Here, we report the first case of transrectal rainage of a retroperitoneal para-aortic abscess after failure f percutaneous drainage. With advantages like avoidance of eneral anaesthesia in critically ill patients and relative ease f access in patients with previous abdominal surgery, the ransrectal retroperitoneoscopic route can be of value, espeially in such difficult clinical settings. EUS guidance can be f help in localizing the abscess if the draining point of the bscess is not visualized during endoscopy. A risk-benefit Figure 2. Para-aortic abscess, perirenal extension.