Mallia Alvin James, Ashwood Neil, Arealis George, Galanopoulos Ilias
Department of Trauma and Orthopaedics, Queens Hospital Burton, Burton on Trent, UK.
BMJ Case Rep. 2015 Jan 9;2015:bcr2014207437. doi: 10.1136/bcr-2014-207437.
Retroperitoneal abscesses are unusual occurrences with occult and insidious presentations. There is often a lack of abdominal signs, leading to delays in drainage and high mortality rates. We report a case of thigh emphysema in an 88-year-old patient with diabetes. Prior to admission the patient reported a vague 4-week history of left thigh pain and an inability to fully weight bear. She presented to our emergency department with sepsis and acute kidney impairment. An X-ray of her left femur revealed widespread gas between muscular planes. A retroperitoneal abscess involving the left renal fossa, psoas, iliacus and upper thigh muscles was revealed on an urgent CT scan. The patient was transferred to intensive care unit (ICU) and underwent an emergency drainage. Despite ICU the patient died 2 days after admission.
腹膜后脓肿较为罕见，临床表现隐匿且不明显。通常缺乏腹部体征，导致引流延迟且死亡率高。我们报告一例88岁糖尿病患者出现大腿气肿的病例。入院前，患者自述左大腿疼痛4周，症状模糊，且无法完全负重。她因败血症和急性肾损伤就诊于我院急诊科。左股骨X线显示肌肉平面间有广泛气体。紧急CT扫描显示腹膜后脓肿累及左肾窝、腰大肌、髂肌和大腿上部肌肉。患者被转入重症监护病房（ICU）并接受了紧急引流。尽管入住了ICU，但患者在入院2天后死亡。
