Ruptured Obturator Internus Muscle Abscess Causing Extensive Retroperitoneal Necrosis

Area of Science:

• Infectious Diseases
• Surgical Pathology
• Radiology

Background:

• Obturator internus muscle (OIM) abscesses are rare in adults, often presenting with nonspecific symptoms.
• Diagnosis can be delayed due to the deep anatomical location and subtle clinical manifestations.

Observation:

• A rare case of a ruptured left OIM abscess initially mimicking acute pancreatitis.
• Contrast-enhanced multidetector computed tomography (MDCT) revealed extensive retroperitoneal necrotizing soft tissue infection.

Findings:

• MDCT demonstrated abscess rupture with widespread fat stranding, fluid, and gas in the perirectal and retroperitoneal spaces.
• Findings indicated extensive necrotizing soft tissue infection secondary to the ruptured OIM abscess.

Implications:

• This case highlights the potential for OIM abscess rupture to cause life-threatening retroperitoneal infections.
• Prompt diagnosis and intervention are critical for managing this rare but potentially fatal condition.