Psoas and Thigh Abscess Caused by Perforated Retrocecal Appendicitis - A Case Report -

Dong-Soo Kim; Yong-Min Kim; Eui Sung Choi; Hyun-Chul Shon; Suri Chong; Seung-myung Choi; Sang-Jun Park

doi:10.4184/jkss.2015.22.1.31

Journal List > J Korean Soc Spine Surg > v.22(1) > 1076073

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Kim, Kim, Choi, Shon, Chong, Choi, and Park: Psoas and Thigh Abscess Caused by Perforated Retrocecal Appendicitis - A Case Report -

Case Report

Journal of Korean Spine Surg 2015;22(1):31-35.

Published online: 21 March 2015

DOI: https://doi.org/10.4184/jkss.2015.22.1.31

Psoas and Thigh Abscess Caused by Perforated Retrocecal Appendicitis - A Case Report -

Dong-Soo Kim, M.D., Yong-Min Kim, M.D., Eui Sung Choi, M.D., Hyun-Chul Shon, M.D., Suri Chong, M.D., Seung-myung Choi, M.D., Sang-Jun Park, M.D.

Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea

Corresponding author: Hyun-chul Shon, M.D. Department of Orthopaedic Surgery, Chungbuk National University Hospital 62, Gaesin-Dong, Cheongju, ChungBuk, 360-711, Korea TEL: +82-43-269-6077, FAX: +82-43-274-8719 E-mail: hyunchuls@chungbuk.ac.kr

Received 16 April 2014 Revised 14 July 2014 Accepted 28 November 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A case report.

Summary of Literature Review

The symptoms of psoas abscess are fever, low back pain, and spasm of the psoas muscle.

Objectives

To report a case of psoas and thigh abscess caused by ruptured appendicitis.

Materials and Methods

A 53- year old male patient visited the complaining of fever, low back pain and thigh pain. Imaging studies revealed psoas abscess and thigh abscess, accompanied by ruptured appendicitis. Therefore, surgical treatment with percutaneous drainage was performed.

Results

The patient recovered and returned to his normal life after 2 months.

Conclusion

It is necessary to identify the cause of the infection using physical examination as well as abdominal and pelvis computed tomography when a patient has fever, psoas abscess and thigh abscess. It is also important to be aware that the cause of psoas abscess may also be gastrointestinal tract disease with non specific symptoms.

Keywords: Appendicitis, Perforation, Psoas abscess, Thigh abscess, Complication

REFERENCES

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Fig. 1.

(A) Axial contrast-enhanced CT scan shows multiple septated abscess in the right psoas muscle larger than left sided, and appendicitis, with leakage between the appendix and retroperotoneal fluid collection.(white arrow) (B) Reconstructed coronal contrast-enhanced CT scan shows dissection of the abscesses in the right thigh via the femoral canal, and shows gas containing abscesses in the right thigh.(white arrow) and heterogenous hypodense lesion with enhanced peripheral rim around appendix (asetrisk).

Fig. 2.

After extensive surgical debridement and hemicolectomy, a percutaneous drainage catheter (arrow) was introduced into the right psoas muscle, and the same procedure (arrow) was performed for the right thigh.

Fig. 3.

(A) Three-month followup axial contrast-enhanced CT scan shows complete resolution (B) Reconstructed coronal contrast-enhanced CT scan also shows resolution. However irregular psoas muscle margine is noted (arrow).

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