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Posterior Approach for Debridement of the Psoas Abscess
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A Case Report of Intradiaphragmatic Abscess
Yuuki Matsui1, Koji Takami1, Reishi Toshiyama2
1Department of General Thoracic Surgery, NHO Osaka National Hospital, Osaka, Osaka, Japan.
Surgical Case Reports
|July 8, 2025
Summary
Intradiaphragmatic abscesses are rare, complicating diagnosis. A combined abdominal and thoracic surgical approach facilitated correct diagnosis and treatment of an intradiaphragmatic abscess caused by Escherichia coli.
Area of Science:
- Medicine
- Surgery
- Infectious Diseases
Background:
- Intradiaphragmatic abscesses are exceptionally rare, posing diagnostic challenges.
- The pathogenesis of these abscesses remains poorly understood due to limited case reports.
Observation:
- A 62-year-old male presented with fever and right chest pain post-cholecystectomy.
- Computed tomography suggested intra-abdominal abscess and right pyothorax, leading to surgical drainage.
- Intraoperative findings revealed a diaphragmatic bulge with pus, positive for Escherichia coli.
Findings:
- A combined laparoscopic and thoracoscopic approach was crucial for diagnosis and treatment.
- The patient recovered well, with no recurrence of the intradiaphragmatic abscess at 18-month follow-up.
Implications:
- A combined abdominal and thoracic approach is recommended for suspected intradiaphragmatic abscesses.
- This approach aids in accurate diagnosis and effective treatment of this rare condition.
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