J Korean Soc Spine Surg.  2015 Mar;22(1):31-35. 10.4184/jkss.2015.22.1.31.

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

• Kim DS
• Kim YM
• Choi ES
• Shon HC
• Chong S
• Choi SM
• Park SJ

• KMID: 1800392
• DOI: http://doi.org/10.4184/jkss.2015.22.1.31

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.
CONCLUSIONS
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.

Keyword

Appendicitis; Perforation; Psoas abscess; Thigh abscess; Complication

MeSH Terms

Abscess*
Appendicitis*
Drainage
Fever
Gastrointestinal Tract
Humans
Low Back Pain
Male
Pelvis
Physical Examination
Psoas Abscess
Psoas Muscles
Spasm
Thigh*

Figure

• 

  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.

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  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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