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Case Reports
. 2020 Dec 13:31:100383.
doi: 10.1016/j.tcr.2020.100383. eCollection 2021 Feb.

Combined approach for intrapelvic abscess drainage among adults

Ayman Khoury  1 , Rami Mosheiff  1 , Khalil Nassrallah  1 , Amal Khoury  2
Affiliations
Case Reports

Combined approach for intrapelvic abscess drainage among adults

Ayman Khoury et al. Trauma Case Rep. .

Erratum in

Abstract

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.

Case: 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.

Methods: 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).

Keywords: Adductor brevis; OIM abscess; Smith Peterson; Stoppa.

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Figures

Fig. 1
Fig. 1
CT axial scan
Fig. 2
Fig. 2
PET-CT scan
Fig. 3
Fig. 3
Stoppa approach, showing the medial wall of the abscess.
Fig. 4
Fig. 4
Smith-Petrson approach, used as a window to reach the lateral wall of the abscess.
Fig. 5
Fig. 5
(a,b): schematic for Stoppa approach:
Fig. 6
Fig. 6
the superficial dissection for Stoppa approach.
Fig. 7
Fig. 7
schematic Smith Peterson approach. (black line, Netter Anatomy Atlas).
See this image and copyright information in PMC

References

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