Psoas and Thigh Abscesses As Rare Complications of Cesarean Delivery: A Case Report

Iliopsoas abscess is an uncommon but potentially severe condition in obstetric practice, posing significant diagnostic challenges due to its deep anatomical location and nonspecific clinical presentation. Its occurrence in the postpartum period, particularly following cesarean delivery, remains exceptionally rare. We report the case of a 32-year-old woman who developed an extensive left iliopsoas abscess with lumbar and thigh extension one week after cesarean section performed for prolonged rupture of membranes. She presented with high-grade fever, severe low back pain, and a tender lumbar swelling complicated by spontaneous fistulization to the thigh. Contrast-enhanced CT demonstrated a large lumbar abscess communicating with a retroperitoneal collection involving the iliopsoas muscle. The patient underwent prompt surgical drainage, yielding approximately 1 L of purulent material, with microbiological culture isolating Staphylococcus aureus. Combined surgical and broad-spectrum antibiotic therapy resulted in a favorable clinical outcome with complete resolution at follow-up. This case underscores the importance of maintaining a high index of suspicion for iliopsoas abscess in postpartum patients presenting with persistent fever and lumbosacral or thigh pain after cesarean delivery. Early imaging, timely intervention, and multidisciplinary management are critical to reducing morbidity and ensuring optimal outcomes.