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Appendicitis presenting as a swollen thigh

L H Sampson, S P Pegg

    The Medical Journal of Australia
    |March 19, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Acute appendicitis can present unusually, with gas-forming abscesses tracking into the thigh. This case highlights the importance of recognizing psoas muscle involvement in diagnosing atypical appendiceal abscesses.

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    Area of Science:

    • Gastroenterology
    • Infectious Disease
    • Surgical Pathology

    Background:

    • Appendicitis is a common surgical emergency, typically presenting with right lower quadrant abdominal pain.
    • Atypical presentations of appendicitis can lead to diagnostic challenges and delayed treatment.
    • Intra-abdominal abscess formation is a known complication of appendicitis.

    Observation:

    • A rare case of acute appendicitis manifested as a gas-forming abscess in the thigh.
    • The abscess formation was associated with the tracking of pus down the psoas muscle.
    • The clinical examination revealed a positive psoas sign, indicative of retroperitoneal irritation.

    Findings:

    • Computed tomography (CT) imaging confirmed the presence of a gas-forming abscess in the thigh, originating from the retroperitoneum.

    Related Experiment Videos

  • The abscess collection was found to have tracked along the path of the psoas major muscle.
  • Microbiological analysis of the abscess aspirate identified polymicrobial infection, including gas-producing organisms.

    • Implications:

    • This case underscores the importance of considering unusual presentations of appendicitis, particularly in the presence of unexplained thigh abscesses.
    • The psoas sign can be a valuable clinical indicator of deep-seated infection tracking along the psoas muscle, even in extrapelvic abscesses.
    • Prompt recognition and surgical intervention are crucial for managing complicated appendicitis with abscess formation to prevent further complications.