Khoury Ayman, Mosheiff Rami, Nassrallah Khalil, Khoury Amal
Orthopedic Department, Hadassah Hospital, Jerusalem, Israel.
Orthopedic Department, Tel-Aviv Sourasky Medical Center, Israel.
Trauma Case Rep. 2020 Dec 13;31:100383. doi: 10.1016/j.tcr.2020.100383. eCollection 2021 Feb.
Obturator internus muscle (OIM) and adductor brevis (AB) abscess occurs rarely in adults. This condition mainly affects children experiencing trauma. This paper presents and discusses a unique case of OIM and AB abscess in an adult male that was treated operatively with a combined surgical approach (modified Stoppa and Smith-Peterson) after multiple failed drainage procedures.
A 23-year-old male underwent reduction and fixation of his right tibiae shaft fracture with an intramedullary nail. After several referrals to the emergency room due to recurrent symptoms of fever and groin pain, he was finally admitted and diagnosed with OIM and AB abscess and fulminant MRSA sepsis. The operative treatment was performed by addressing the abscess with an unusual combined surgical approach (Smith-Peterson and modified Stoppa) for abscess drainage.
Using PubMed, Google scholar and Hadassah Hebrew University search engines, we conducted a literature search using the following keywords: 'pyomyositis', 'obturator abscess', 'pelvic abscess', and 'pelvic osteomyelitis among children and adults'. Twenty case studies were found (14 children and 6 adults). No cases of combined OIM and AB abscess were found and only one OIM case was reported with methicillin-resistant Staphylococcus (MRSA).
闭孔内肌（OIM）和短收肌（AB）脓肿在成人中很少见。这种情况主要影响遭受创伤的儿童。本文介绍并讨论了一例成年男性的OIM和AB脓肿的独特病例，该病例在多次引流手术失败后，采用联合手术方法（改良的Stoppa和Smith-Peterson）进行了手术治疗。
一名23岁男性接受了右胫骨干骨折的髓内钉复位固定术。由于反复出现发热和腹股沟疼痛症状，多次转诊至急诊室后，他最终入院并被诊断为OIM和AB脓肿以及暴发性耐甲氧西林金黄色葡萄球菌败血症。通过采用一种不寻常的联合手术方法（Smith-Peterson和改良的Stoppa）进行脓肿引流来实施手术治疗。
使用PubMed、谷歌学术和哈达萨希伯来大学搜索引擎，我们使用以下关键词进行了文献检索：“脓性肌炎”、“闭孔脓肿”、“盆腔脓肿”以及“儿童和成人盆腔骨髓炎”。共找到20个病例研究（14例儿童和6例成人）。未发现OIM和AB脓肿合并的病例，仅报告了1例耐甲氧西林葡萄球菌（MRSA）感染的OIM病例。
