Park Hye Jeong, Jeon Yong Cheol, Lee Kyeonga, Byun Tae Jun, Kim Tae Yeob, Eun Chang Soo, Han Dong Soo, Sohn Joo Hyun
Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea.
Korean J Gastroenterol. 2008 Sep;52(3):188-91.
A psoas abscess (PA) is a rare clinical entity but is potentially serious condition which presents diagnostic and therapeutic challenges. The diagnosis is frequently delayed due to its variable and nonspecific features and occult clinical course. The delay in diagnosis and treatment of PA is the major poor prognostic factor. We describe herein a case of the sterile psoas abscess complicating Cronh's disease which presented as hip flexion contracture. A 29-year-old man, at remission stage of CD involving ileocolic segment, was admitted due to pain from hip contracture. He had no bloody diarrhea and no abdominal pain. PA was confirmed by abdominal ultrasound. PA with hip contracture was completely treated with surgical excision, irrigation, drainage, and antibiotics. PA was sterile and there was no evidence of a fistulous communication from the bowel. Once suspected, aggressive diagnostic work up and definitive operative intervention is needed.
腰大肌脓肿(PA)是一种罕见的临床病症,但却是一种潜在的严重疾病,会带来诊断和治疗方面的挑战。由于其表现多样且不具特异性,临床病程隐匿,诊断常常延迟。PA诊断和治疗的延迟是主要的不良预后因素。我们在此描述一例克罗恩病并发无菌性腰大肌脓肿的病例,该病例表现为髋关节屈曲挛缩。一名29岁男性,处于克罗恩病回结肠段缓解期,因髋关节挛缩疼痛入院。他没有血便和腹痛。腹部超声证实存在腰大肌脓肿。伴有髋关节挛缩的腰大肌脓肿通过手术切除、冲洗、引流及使用抗生素得到了彻底治疗。腰大肌脓肿是无菌性的,且没有肠道瘘管相通的证据。一旦怀疑,需要积极进行诊断检查并进行确定性手术干预。