Kudret SELKİ, Mehmet Cihat DEMİR, Mustafa BOĞAN

An Aortic Abscess Associated with Psoas Abscess: A Case Report

Anahtar Kelimeler:

psoas abscess, Aortic abcess, aneurysmatic

An Aortic Abscess Associated with Psoas Abscess: A Case Report

In this article, we report a case in which a psoas abscess opened into the aneurysmatic abdominal aorta, and abscess formation was observed in the aortic lumen containing a stent. A 57-year-old male patient presented to the emergency department with a complaint of abdominal pain. During the abdominal examination of the patient, tenderness and defense were detected in the right lower quadrant. Contrast-enhanced computed tomography (CT) angiography of the abdominal aorta was ordered because the patient had a history of previous stenting and right lower quadrant deficiency. In the right iliopsoas muscle, there was an increase in size suggestive of abscess formation with air densities. The diameter of the ascending aorta was 44 mm. At the level of the descending thoracic aortic bifurcation, an aneurysmatic appearance was noted in a segment of approximately 140 mm extending to the proximities of both main iliac arteries, and USG showed air in the wall in the aneurysmatic section and mural wall thickening with thrombus. In this case, although the abscess eroded the aneurysmatic aortic wall, acute bleeding did not develop due to the presence of a stent. We wanted to share the rare image on computed tomography (massive air-fluid level around the stent in the aortic lumen), especially in our case with the medical literature.

Keywords:

psoas abscess, Aortic abcess, aneurysmatic,

PDF

___

Mallick IH, Thoufeeq MH, Rajendran TP. Iliopsoas abscesses. Postgrad Med J. 2004;80(946):459-462.
Coşarderelioğlu Ç, Bahşi R, Öztorun HS, Atmış V, Yalçın A, Aras S, et al. An Atypical Case of Psoas Abscess in an Elderly Patient. Eur J Geriatr Gerontol. 2019; 1(1): 40-42.
Ruiz de la Hermosa A, Amunategui-Prats I, Hurtado-Caballero E, Cortese S, Muñoz-Calero Peregrin A. Psoas abscess due to Pasteurella multocida. Rev Gastroenterol Mex. 2011;76(4):366-369.
Ma JW, Hu SY, Lin TC, Tsai CA. Psoas abscess associated with aortic endograft infection caused by bacteremia of Listeria monocytogenes: A case report and literature review (CARE Complaint). Medicine (Baltimore). 2019;98(45):e17885.
Askin A, Bayram KB, Demirdal US, Korkmaz MB, Gurgan AD, Inci MF. An easily overlooked presentation of malignant psoas abscess: hip pain. Case Rep Orthop. 2015;2015:410872.
Singh A, De Silva P, Chamberlain J, Deshpande A. Anaplastic large cell lymphoma mimicking a psoas abscess. Journal of Pediatric Surgery Case Reports. 2020; 55: 101410.
Linn YL, Ng NZP, Tang TY, Chong TT. Endoleak Complicated by communicating psoas abscess and aorto-enteric fistula in an immunocompromised patient. Ann Vasc Surg. 2022;78:378.e23-378.e29.
Mitsutake, A., Matsumoto, H., Hatano, K., Matsuura, S., Takayama, T., Yamamoto, K., ... & Hashida, H. (2018). Pneumococcal meningitis with vertebral osteomyelitis, iliopsoas abscess, and infected abdominal aortic aneurysm. Neurology and Clinical Neuroscience, 6(1), 23-25.
Hu SY, Hsieh MS, Chang YT, Huang CC, Tsai CA, Tsai CL, et al. Clinical features, management, and outcome of iliopsoas abscess associated with cardiovascular disorders: a hospital-based observational case series study. BMC Musculoskelet Disord. 2019;20(1):474.
Takada T, Terada K, Kajiwara H, Ohira Y. Limitations of using imaging diagnosis for psoas abscess in its early stage. Intern Med. 2015;54(20):2589-2593.
Inufusa A, Mikawa Y, Morita I, Fujiwara T. Ruptured abdominal aortic aneurysm associated with a psoas abscess. Arch Orthop Trauma Surg. 2002;122(5):306-307.