Neonatal and Pediatric Medicine
Open Access

Case Report

Recurrent Psoas Abscess associated with Retrocecal Appendicitis in an Adolescent Female

¹Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children’s Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Fu-Hsin Street, Gueishan District, 33305, Taoyuan City, Taiwan

²Divison of Pediatric Surgery, Department of Pediatrics, Chang Gung Children’s Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Fu-Hsin Street, Gueishan District, 33305, Taoyuan City, Taiwan

³Division of Pediatric Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan

*Corresponding Author:

Hsun-Chin Chao
Associate Professor
Division of Pediatric Gastroenterology
Department of Pediatrics
Chang Gung Children’s Medical Center
Chang Gung Memorial Hospital
Chang Gung University College of Medicine
5 Fu-Hsin Street, Gueishan District
33305, Taoyuan City, Taiwan
Fax: 886-3-3288957
E-mail: chahero@yahoo.com

Received: November 18, 2015; Accepted: December 01, 2015; Published: December 07, 2015

Citation: Chao HC, Ming YC, Luo CC (2015) Recurrent Psoas Abscess associated with Retrocecal Appendicitis in an Adolescent Female. Neonat Pediatr Med 1: 101. doi:10.4172/2572-4983.1000101

Copyright: © 2015 Chao HC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Psoas abscess (PA) is encountered infrequently in children. Pyogenic psoas abscess is most commonly a primary process associated with Staphylococcus aureus in children. Herein we present a female adolescent of secondary psoas abscess associated with ruptured retrocecal appendicitis, and it was successfully treated by broadspectrum antibiotics and prompt surgical intervention. The patient was a case of ruptured appendicitis with successful conservative treatment. The patient missed the follow-up schedule for elective interval appendectomy. Two years later, she presented with fever, limping gait, and right flank pain. Ultrasound revealed fixed dilated bowel loops, a fecalith and a heterogeneous hypoechoic lesion (3.7×3.6×3.3 cm) at right psoas muscle, suspecting PA. The patient received intravenous antibiotics for 2 weeks and made an excellent recovery. A follow-up ultrasound showed complete resolution of the abscess. The patient missed the schedule for interval appendectomy again, and same symptoms recurred 4 months later. Laboratory data indicated leukocytosis and marked elevation of serum Creactive protein. Computed tomography scan of the abdomen showed a gas-containing fluid collection within the right psoas muscle, and connecting with a dilated appendix. Laparotomy with appendectomy and tube drainage of the abscess was done, and the patient had uneventful recovery. The bacterial culture of pus grew Enterobacter cloacae. The patient discharged eight days after surgery. Neither abdominal symptoms nor evidence of recurrent PA on follow-up ultrasound was observed in the later years.

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