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Unusual presentation of psoas abscess  _a case
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Unusual presentation of psoas abscess _a case

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it is an unusual clinical presentation of psoas abscess

it is an unusual clinical presentation of psoas abscess

Published in: Health & Medicine

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  • 1. BY: Dr. Rekha KhareMD RADIOLOGY
  • 2.  A young man 37yr painter by occupationcame to medical out patient departmentwith painful lump in left flank for about twomonths. There was history of low gradepyrexia and constitutional symptoms
  • 3.  Tender lump palpable in left renal fossa No significant hip flexion deformity
  • 4.  Raised white blood count Raised C-reactive protein
  • 5.  Thick walled complex echo mass in left renalfossa not connected to left kidney Slightly thick psoas muscle with no fluid B/L renal/ureteric calculi withhydronephrosis Moderate Hepatosplenomegaly
  • 6. CT was done after 3 days of u/s exam Bulky left psoas muscle with collection inmuscular plane Left psoas breaking anterio-superiorly in to awell enhanced huge thick walled multi-loculated pocket Extension was noted laterally in superficialabdominal wall Tiny abscess was also seen in left paraspinalregion
  • 7.  Left sided bowels displaced medially B/L renal/ureteric calculi with moderatehydronephrosis Moderate hepatosplenomegaly
  • 8.  Left chronic psoas abscess (ruptured/extension extraperitoneal) B/L hydronephrosis( Rt ureteric and left renal calculus)
  • 9.  Surgical drainage was done Broad spectrum antibiotics given Later on Anti tubercular treatment whenAAFB was found +ve in pus
  • 10.  Case came for painful lump left abdomen Clinically no hip flexion, an important sign infavor of psoas abscess Initial U/S showed no communicationbetween lump and psoas muscle
  • 11.  Sometimes it is difficult to identify psoasabscess on first visit Repeated appropriate imaging should beconsidered if initial imaging is notcompatible with clinical presentation Microbiology of psoas abscess varies withgeography. In endemic area abscess may besecondary to Mycobactrium Tuberculosis
  • 12.  Unusual presentation of psoas abscess in achild.J pediatr surg. 2001Dec.36(12)1859-60Ixheimer O. Cohen Z. Barki Y. Marks A. J Case report: Psoas abscess- unusualetiology of Groin painMed Gen Med. 2005,7(3):10Manoj Todkar
  • 13.  An unusual case of a psoas abscess.Irshad W. Gupta S. Katz ADeptt of Medicine ohn H Stroger JrHospital of Cook County Chicago

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