Right Psoas Abscess as a Consequence of Ruptured Appendix with Caecal Perforation and Presenting as Right Lumbar Swelling in a Toddler: A Rare Presentation of Appendicitis
Psoas Abscess (PA) is a very rare form of presentation of appendicular pathology, especially in a toddler. A three-year-old male child presented to the casualty with complaint of right lumbar swelling for 14 days. There was no other significant history. On clinical examination, there was 5×5 cm righ...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2019-08-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/13090/42059_CE[Ra1]_F(KM)_PF1(KM_AG)_PN(SL).pdf |
| _version_ | 1818334250512941056 |
|---|---|
| author | Rafey Abdul Rahman Umesh Kumar Gupta |
| author_facet | Rafey Abdul Rahman Umesh Kumar Gupta |
| author_sort | Rafey Abdul Rahman |
| collection | DOAJ |
| description | Psoas Abscess (PA) is a very rare form of presentation of appendicular pathology, especially in a toddler. A three-year-old male child presented to the casualty with complaint of right lumbar swelling for 14 days. There was no other significant history. On clinical examination, there was 5×5 cm right lumbar swelling with a prominent bulge, which was non tender. USG and Contrast Enhanced Commuted Tomography (CECT) abdomen revealed PA which was drained by incision made on the bulge. There was feculent output noted from the incision and drainage site the following day. Child underwent exploratory laparotomy and was found to have ruptured partially sloughed of appendix along with perforated caecum going deep to the psoas muscle which in turn was communicating via tract to the incision and drainage site. Residual appendectomy along with caecal repair was done. Diverting proximal loop ileostomy was made and an abdominal drain was placed. Postoperatively, the child recovered well and was discharged on postoperative day 5 with a functioning ileostomy and on full oral feeds. In the follow-up distal cologram was done which revealed free flow of contrast along the entire colon up to rectum. The child has now been planned for stoma closure. Prompt diagnosis and prompt intervention was responsible for significantly reducing morbidity in the present case. |
| first_indexed | 2024-12-13T14:04:33Z |
| format | Article |
| id | doaj.art-3cd9dff36448403ca75808a249fd8968 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-13T14:04:33Z |
| publishDate | 2019-08-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-3cd9dff36448403ca75808a249fd89682022-12-21T23:42:38ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2019-08-01138PD03PD0510.7860/JCDR/2019/42059.13090Right Psoas Abscess as a Consequence of Ruptured Appendix with Caecal Perforation and Presenting as Right Lumbar Swelling in a Toddler: A Rare Presentation of AppendicitisRafey Abdul Rahman0 Umesh Kumar Gupta1Assistant Professor, Department of Paediatric Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.Assistant Professor, Department of Paediatric Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.Psoas Abscess (PA) is a very rare form of presentation of appendicular pathology, especially in a toddler. A three-year-old male child presented to the casualty with complaint of right lumbar swelling for 14 days. There was no other significant history. On clinical examination, there was 5×5 cm right lumbar swelling with a prominent bulge, which was non tender. USG and Contrast Enhanced Commuted Tomography (CECT) abdomen revealed PA which was drained by incision made on the bulge. There was feculent output noted from the incision and drainage site the following day. Child underwent exploratory laparotomy and was found to have ruptured partially sloughed of appendix along with perforated caecum going deep to the psoas muscle which in turn was communicating via tract to the incision and drainage site. Residual appendectomy along with caecal repair was done. Diverting proximal loop ileostomy was made and an abdominal drain was placed. Postoperatively, the child recovered well and was discharged on postoperative day 5 with a functioning ileostomy and on full oral feeds. In the follow-up distal cologram was done which revealed free flow of contrast along the entire colon up to rectum. The child has now been planned for stoma closure. Prompt diagnosis and prompt intervention was responsible for significantly reducing morbidity in the present case.https://jcdr.net/articles/PDF/13090/42059_CE[Ra1]_F(KM)_PF1(KM_AG)_PN(SL).pdfcomplicated retro-caecal appendicitisfaecal fistulapyogenic abscess |
| spellingShingle | Rafey Abdul Rahman Umesh Kumar Gupta Right Psoas Abscess as a Consequence of Ruptured Appendix with Caecal Perforation and Presenting as Right Lumbar Swelling in a Toddler: A Rare Presentation of Appendicitis Journal of Clinical and Diagnostic Research complicated retro-caecal appendicitis faecal fistula pyogenic abscess |
| title | Right Psoas Abscess as a Consequence of Ruptured Appendix with Caecal Perforation and Presenting as Right Lumbar Swelling in a Toddler: A Rare Presentation of Appendicitis |
| title_full | Right Psoas Abscess as a Consequence of Ruptured Appendix with Caecal Perforation and Presenting as Right Lumbar Swelling in a Toddler: A Rare Presentation of Appendicitis |
| title_fullStr | Right Psoas Abscess as a Consequence of Ruptured Appendix with Caecal Perforation and Presenting as Right Lumbar Swelling in a Toddler: A Rare Presentation of Appendicitis |
| title_full_unstemmed | Right Psoas Abscess as a Consequence of Ruptured Appendix with Caecal Perforation and Presenting as Right Lumbar Swelling in a Toddler: A Rare Presentation of Appendicitis |
| title_short | Right Psoas Abscess as a Consequence of Ruptured Appendix with Caecal Perforation and Presenting as Right Lumbar Swelling in a Toddler: A Rare Presentation of Appendicitis |
| title_sort | right psoas abscess as a consequence of ruptured appendix with caecal perforation and presenting as right lumbar swelling in a toddler a rare presentation of appendicitis |
| topic | complicated retro-caecal appendicitis faecal fistula pyogenic abscess |
| url | https://jcdr.net/articles/PDF/13090/42059_CE[Ra1]_F(KM)_PF1(KM_AG)_PN(SL).pdf |
| work_keys_str_mv | AT rafeyabdulrahman rightpsoasabscessasaconsequenceofrupturedappendixwithcaecalperforationandpresentingasrightlumbarswellinginatoddlerararepresentationofappendicitis AT umeshkumargupta rightpsoasabscessasaconsequenceofrupturedappendixwithcaecalperforationandpresentingasrightlumbarswellinginatoddlerararepresentationofappendicitis |