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Metal shrapnel causing psoas abscess: The first case report

Maher Al-Hajjaj1, Mohammad Alsultan2, Sarya Swed3

  • 1Department of Urology, Aleppo University Hospital, Aleppo, Syria.

International Journal of Surgery Case Reports
|June 13, 2021
PubMed
Abstract

Insights

This case report details the first instance of a psoas abscess caused by metal shrapnel from a landmine explosion. Prompt surgical drainage and antibiotic treatment were crucial for recovery, highlighting the need for strict evaluation after penetrating trauma.

Area of Science:

  • Urology
  • Trauma Surgery
  • Infectious Diseases

Background:

  • Iliopsoas abscess involves pus accumulation around the psoas and iliac muscles.
  • While foreign bodies can cause these abscesses, metal shrapnel is an unprecedented etiology.
  • Penetrating trauma, such as from landmines, presents unique diagnostic and management challenges.

Purpose of the Study:

  • To report the first known case of an iliopsoas abscess caused by metal shrapnel.
  • To emphasize the importance of thorough evaluation in patients with penetrating trauma.
  • To discuss the management of complex iliopsoas abscesses.

Main Methods:

  • A 41-year-old male with a history of landmine explosion presented with symptoms of septicemia and low back pain.
  • Computed tomography (CT) revealed a right psoas abscess containing metal shrapnel.
  • The abscess was drained via an anterolateral approach, and the shrapnel was surgically removed.

Main Results:

  • Successful drainage of the retroperitoneal abscess and extraction of the metal shrapnel were achieved.
  • The patient experienced no recurrence of the abscess during a 6-month follow-up period.
  • Computed tomography proved effective in diagnosing the condition.

Conclusions:

  • Psoas abscess secondary to metal shrapnel requires emergent treatment, including broad-spectrum antibiotics and open surgical drainage.
  • Patients with penetrating trauma necessitate rigorous evaluation to identify potential complications like abscess formation.
  • Close follow-up is vital for individuals with a history of explosive device injuries.
Keywords:
Case reportForeign bodyPsoas abscessRetroperitoneal abscess

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