Clin Orthop Surg.  2011 Dec;3(4):342-344. 10.4055/cios.2011.3.4.342.

Psoas Abscess Caused by Spontaneous Rupture of Colon Cancer

• Yang JY
• Lee JK
• Cha SM
• Joo YB

• KMID: 1097174
• DOI: http://doi.org/10.4055/cios.2011.3.4.342

Abstract

Spontaneous rupture of colon cancer, combined with psoas abscess formation, is rare. A 44-year-old male visited for back pain and left buttock mass. Abdominal computed tomography and magnetic resonance image revealed a large abscess in the left psoas muscle and in the left lower quadrant area. Ten days after incision and drainage, a skin defect around the left anterior superior iliac spine remained. A local flap was performed using a superficial skin graft. Ten days after the stitches had been removed, fecal discharge was observed around the anterior superior iliac spine at the flap site. An operation was performed by a general surgeon who had diagnosed this as a case of enterocutaneous fistula. Operative findings included a ruptured tumor mass in the descending colon, which was connected to a retroperitoneal abscess. Pathologic report findings determined adenocarcinoma of the resected colon. Herein, we report a case of psoas abscess resulting from perforating colon cancer.

Keyword

Psoas abscess; Colon cancer; Spontaneous rupture

MeSH Terms

Adult
Colonic Neoplasms/*complications
Humans
Male
Psoas Abscess/*etiology
Rupture, Spontaneous/complications
Streptococcal Infections/*etiology

Figure

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  Fig. 1 A gross photograph of left buttock mass and erythematous skin eruption.

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  Fig. 2 (A) Abdominal computed tomography, revealing abscess formation on the left psoas muscle, which was depicted as a localized low density area. (B) Magnetic resonance imaging shows multiseptated psoas abscess and gluteal abscess.

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  Fig. 3 A gross photograph suggestive of enterocutaneous fistula on the 10th postoperative day.

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  Fig. 4 The resected descending colon with spontaneous rupture. The sinus tract is not visible in this view.

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