Antalgic flexion of the lower limb: an unusual presentation of aortoiliac infection with psoas muscle abscess-four case reports.
Psoas abscess with aortoiliac infection is rare. Patients are often symptomatic for a long time before the correct diagnosis is made. The authors report 4 cases in which the presenting symptom was an antalgic flexion of the left thigh. In 2 patients the cause was an aortic graft infection with enteric fistula; in the other 2, infection developed after transfemoral endovascular procedures. Open surgical treatment was performed in 3 cases and percutaneous drainage in 1. One surgical patient with a late diagnosis eventually died of sepsis; the other 3 are alive and well at mean follow-up of 14 months.
Melissano
Germano
G
Chair of Vascular Surgery, Vita-Salute University, Scientific Institute H. San Raffaele, Milan, Italy. g.melissano@hsr.it
Civilini
Efrem
E
Papa
Maurizio
M
Del Guercio
Raffaele
R
Chiesa
Roberto
R
D000368:Aged; D017541:Aneurysm, False / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001012:Aorta, Abdominal / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000382:microbiology*; D003646:Debridement; D004322:Drainage / Q000379:methods; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D007412:Intestinal Fistula / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000628:therapy; D016659:Psoas Abscess / Q000382:microbiology* / Q000628:therapy
D000900:Anti-Bacterial Agents