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Case Report

Med Arch. 2022; 76(4): 308-312


Iliopsoas Hematoma and Abscess Formation as a Complication of an Anterior Abdominal Penetrating Injury: a Case Report and Review of Literature

Humood Ahmed Alsadery, Mohamad Zaki Alzaher, Adel Gaafar Elbagir Osman, Mamoun Nabri, Abrar Hasan Bukhamseen, Abdulrahman Alblowi, Ibrahim Aldossery.




Abstract

opment of psoas muscle abscess following such an injury is extremely rare. Moreover, literature surrounding psoas muscle hematoma formation as a consequence of penetrating abdominal injury is scarce. Objective: We report a case of psoas abscess formation following the development of psoas hematoma in a patient who suffered from a penetrating abdominal injury. Case presentation: A 40-year-old Indian male presented to the Emergency department with multiple abdominal cut and stab wounds as a result of physical assault. A computed tomography scan revealed injuries to the ascending colon along with hemoperitoneum and right psoas muscle hematoma. Exploratory laparotomy was performed in which a right hemicolectomy and a right psoas muscle evacuation were successfully achieved along with multiple drainage tubes placed. Six days later, a peritoneal fluid culture tested positive, and a computed tomography scan revealed right psoas muscle collection which was diagnosed as an abscess. Treatment of the abscess included antibiotics and ultrasound-guided drainage. Patient was eventually discharged but was lost to follow-up. Conclusion: The development of iliopsoas abscess and hematoma as a consequence of abdominal penetrating injuries is a rare occurrence. Diagnosis can be made by computed tomography imaging and examination of the drained fluid. Managing a case with both of these rare phenomena can be challenging due to the scarce literature highlighting and comparing the different management modalities.

Key words: Hematoma, psoas abscess, penetrating wound.






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