Document Type: Case Report

Authors

1 General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Department of Internal Medicine, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Psoas abscesses could originate from an adjacent source of infection in the abdominopelvic cavity known as a secondary complication of acute appendicitis. However, it is considered as a very rare event when occurring late after the presentation of appendicitis. Whether it is the source or complication of acute appendicitis following appendectomy remains unclear. A 25-year-old man was admitted to our center with fever and abdominal pain. His past medical history was unremarkable except for having an acute appendicitis and complicated appendectomy 4 years before presenting illness. On admission, the patient was febrile with right lower quadrant abdominal tenderness and moderate leukocytosis. The Abdominopelvic CT- scan revealed a large right psoas muscle than the opposite site, that contained a hypodense mass measuring 6 cm in diameter with extension into right iliacus and internal oblique muscles..The patient underwent subsequent percutaneous abscess drainage under image guide and concurrent broad-spectrum antibiotic therapy.

Keywords

  1. Turunç T, Turunç T, Demiroğlu YZ, Colakoğlu S. Retrospective evaluation of 15 cases with psoas abscesses. Mikrobiyol Bul 2009;43(1):121-5.
  2. Garner JP, Meiring PD, Ravi K, Gupta R. Psoas abscess - not as rare as we think? Colorectal Dis 2007;9(3):269-74.
  3. Navarro V, Meseguer V, Fernandez A, Medrano F, Saez JA, Puras A. Psoas muscle abscess.Description of a series of 19 cases. Enferm Infecc Microbiol Clin 1998;16(3):118-22.
  4. Ricci MA, Rose FB, Meyer KK. Pyogenic psoas abscess: worldwide variations in aetiology. World J Surg 1986;10(5):834-43.
  5. Huang JJ, Ruaan MK, Lan RR, Wang MC. Acute pyogenic iliopsoas abscess in Taiwan: clinical features, diagnosis, treatments and outcome. J Infect 2000;40(3):248-55.
  6. Di Marco L, Sciascia V, Salmi R, Manfredini A, Cocuzza C, Berghenti M. Psoas abscess ten years after ipsilateral nephrectomy for pyonephrosis. G Chir 2007;28(4):139-41.
  7. Hsieh CH, Wang YC, Yang HR, Chung PK, Jeng LB, Chen RJ. Retroperitoneal abscess resulting from perforated acute appendicitis: analysis of its management and outcome. Surg Today 2007;37(9):762-7.
  8. Moosmayer S. Abdominal actinomycosis.Actinomycotic abscess 10 years after appendectomy. Tidsskr Nor Laegeforen 1992;112(22):2857-8.
  9. Korenkov M, Yücel N, Schierholz JM, Goh P, Troidl H. Psoas abscesses. Genesis, diagnosis, and therapy. Chirurg 2003;74(7):677-82.
  10. Dahami Z, Sarf I, Dakir M, Aboutaieb R, Bennani S, Elmrini M, et al. Treatment of primary pyogenic abscess of the psoas: retrospective study of 18 cases. Ann Urol (Paris) 2001;35(6):329-34.
  11. el Hassani S, Echarrab el-M, Bensabbah R, Attaibi A, Kabiri H, Bourki K, et al. Primary psoas abscess. A review of 16 cases. Rev Rhum Engl Ed 1998;65(10):555-9.
  12. Penado S, Espina B, Francisco Campo J. Abscess of the psoas muscle. Description of a series of 23 cases. Enferm Infecc Microbiol Clin 2001;19(6):257-60.
  13. Lin MF, Lau YJ, Hu BS, Shi ZY, Lin YH. Pyogenic psoas abscess: analysis of 27 cases. J Microbiol Immunol Infect 1999;32(4):261-8.
  14. Olivares D, Navarro-Lopez V, Serrano R, Lopez-Garcia F. Brucellosis complicated by a psoas muscle abscess. Enferm Infecc Microbiol Clin 2004;22(3):200.
  15. Kaya S, Sayil O. Psoas abscess due to brucellosis. Trop Doct 2009;39(2):124-7.
  16. Rabii R, el Moussaoui A, Rais H, Debbagh A, el Mrini M, Benjelloun S. Primary pyogenic abscess of the psoas muscle.Apropos of 5 cases. Ann Urol (Paris) 1997;31(6-7):361-5.
  17. Perez-Fernandez S, de la Fuente-Aguado J, Fernandez-Fernandez FJ, Rubianes-Gonzalez M, Sopeña Perez-Argüelles B, Martinez-Vazquez C. Psoas abscesses. An up-dated perspective. Enferm Infecc Microbiol Clin 2006;24(5):313-8.
  18. MacGillivray DC, Valentine RJ, Johnson JA 3rd. Strategies in the management of pyogenic psoas abscesses. Am Surg 1991;57(11):701-5.
  19. Jeffrey RB, Callen PW, Federle MP. Computed tomography of psoas abscesses. J Comput Assist Tomogr 1980;4(5):639-41.
  20. Chen YC, Chen ST, Chen YS. Psoas abscess: report of a case. Taiwan Yi Xue Hui Za Zhi 1989;88(7):752-4.
  21. Lapus RM, Baker MD. An uncommon late complication of appendicitis. Pediatr Emerg Care 2010;26(10):757-8.