Giant primary psoas abscess: masquerading peritonitis-for diagnosis and treatment

Abstract

Primary psoas abscess is a distinct clinical entity with vague clinical presentation and obscure pathogenesis, although the literature regarding it is sparse. Psoas muscle abscess is an uncommon clinical phenomenon, extremely difficult to diagnose and needs to be investigated with considerable thoroughness. We emphasize the importance of ultrasonography and computed tomography along with role of the treatment. A 15-year old female presented with pain and distention of the abdomen. We report an extremely rare case of bilateral giant psoas abscess diagnosed as peritonitis. Ultrasonography showed abscess of the left psoas muscle which ruptured anteriorly into the peritoneal cavity and caused intraperitoneal abscess but computed tomography revealed different picture. In our case, computed tomography has the main role in the diagnosis/management of the psoas abscess. Conservative treatment was given using antibiotics and drainage. The patient was discharged in good condition. In follow-up period of 9 months, she remained well and asymptomatic.