Psoas muscle abscess simulating acute appendicits: A case report

Area of Science:

• Medical Case Reports
• Surgical Case Studies
• Infectious Disease Research

Background:

• Psoas abscess is a rare condition with non-specific symptoms, often leading to diagnostic challenges.
• It can present with pain in the hip, back, or abdomen, and may mimic other acute abdominal conditions.
• Early diagnosis is crucial for effective management and to prevent complications.

Purpose of the Study:

• To report a case of psoas abscess that initially presented with symptoms suggestive of acute appendicitis.
• To emphasize the diagnostic utility of Computed Tomography (CT) scans in identifying psoas abscess.
• To discuss the clinical presentation, diagnostic challenges, and management of psoas abscess.

Main Methods:

• A 25-year-old male presented with right iliac fossa and lumbar pain, initially managed as suspected appendicitis.
• Diagnostic workup included laboratory tests, abdominal ultrasound, and subsequently a contrast-enhanced abdominal CT scan.
• Treatment involved surgical drainage of the abscess and antibiotic therapy.

Main Results:

• Initial presentation mimicked acute appendicitis, leading to an appendectomy.
• Post-operative worsening of symptoms prompted further investigation with CT scan, revealing a large psoas abscess.
• Successful retroperitoneal drainage of 300ml purulent fluid and subsequent Penrose drain placement led to good recovery.

Conclusions:

• Psoas abscess is an underdiagnosed condition that can present atypically, mimicking more common surgical emergencies like appendicitis.
• CT scan is a valuable imaging modality for diagnosing psoas abscess, aiding in timely surgical intervention.
• Effective treatment involves surgical drainage and appropriate antibiotic therapy.