Late onset ilio-psoas abscess due to stump appendicitis: a case report

We describe a case of right ilio-psoas abscess caused by stump appendicitis 14 years after open appendectomy. Stump appendicitis is a rare complication of appendectomy. Right ilio-psoas abscess was diagnosed in an immune-competent patient and treated by ultrasound guided percutaneous drainage twice without identifying the cause of the abscess. The patient did not improve until diagnostic laparoscopy was performed revealing a long stump appendicitis to be the origin of infection. It was treated by completion appendectomy. Surgical exploration may be necessary in persistent or recurrent ilio-psoas abscesses. We identified 4 reported cases of post-appendectomy ilio-psoas abscess but without recognizing the cause of the abscess and its relation to appendectomy. This is the first reported case of ilio-psoas abscess that developed as a complication of stump appendicitis.