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 AppendicitisCorrespondence Address :
Dr. Umesh Kumar Gupta,
Type 4, Block-C, Room No-202, New Campus, 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.
Complicated retro-caecal appendicitis, Faecal fistula, Pyogenic abscess
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 [serial online] 2019 August [cited: 2019 Aug 20 ]; 13:PD03-PD05. Available from
Date of Submission: May 20, 2019
Date of Peer Review: Jun 10, 2019
Date of Acceptance: Jul 16, 2019
Date of Publishing: Aug 01, 2019
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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