Soni Aditya, Munshi Sandeep, Shirodkar Kapil, Soni Ashutosh, Dhanopeya Ajay, Radhamony Niranj G, Sreenivasan Sachith
Trauma and Orthopaedics, Furness General Hospital, Barrow-in-Furness, GBR.
Radiology, Royal Lancaster Infirmary, Lancaster, GBR.
Cureus. 2022 Apr 7;14(4):e23927. doi: 10.7759/cureus.23927. eCollection 2022 Apr.
Colonic diverticulitis is one of the common causes of surgical intervention in general surgical practice. In most cases, surgical intervention depends on the presence of a collection around the sigmoid colon, the feasibility of percutaneous drainage, and the patient's medical condition. The collection can occur in the thigh in rare cases due to a fistulous communication with the retroperitoneum and can track gravitationally along the psoas muscle into the thigh and leg without any discernible collection around the sigmoid colon or in the abdominal cavity. We came across a similar case of a 54-year-old man who presented with abdominal pain, and thigh and leg swelling. Left-sided colonic diverticulitis was seen without any discernible abdominal collection and a thigh abscess during the initial clinical presentation. He was treated with multiple drainages of the thigh abscess, ultimately followed by a Hartmann's procedure over a total hospital admission period of 52 days. Current literature does not throw much light on such a situation and makes it all the more critical to illustrate this case. We present this rare case and give a complete account of investigations, disease course, and the interventions done to throw light on the optimal management of such cases.
结肠憩室炎是普通外科手术干预的常见原因之一。在大多数情况下，手术干预取决于乙状结肠周围是否存在积液、经皮引流的可行性以及患者的病情。在极少数情况下，由于与腹膜后存在瘘管相通，积液可出现在大腿，并且可沿腰大肌向重力方向蔓延至大腿和小腿，而乙状结肠周围或腹腔内无任何可察觉的积液。我们遇到了一例类似病例，一名54岁男性，表现为腹痛、大腿和小腿肿胀。在初始临床表现时，发现左侧结肠憩室炎，无任何可察觉的腹部积液及大腿脓肿。他接受了多次大腿脓肿引流治疗，最终在住院52天期间接受了哈特曼手术。目前的文献对此种情况阐述不多，因此说明该病例显得尤为重要。我们展示此罕见病例，并完整描述检查、病程及所采取的干预措施，以阐明此类病例的最佳管理方法。
