A problem in diagnostic imaging.
Many pathological processes can present as a swelling in the groin. We present a case of complex, ruptured pyonephrosis causing a psoas collection, which in turn presented clinically as an apparent right "incarcerated inguinal hernia." The patient was successfully treated with antibiotics and ultrasound-guided drainage of the abscess. The anatomical basis of the inguinal presentation of this complex pyonephrosis can be understood in the arrangement of the renal (Gerota's) fascia.
Raymond
A C
AC
Department of Urology, The Ipswich Hospital NHS Trust, Ipswich, United Kingdom. acraymond@doctors.org.uk
Cutress
M L
ML
Sathesh-Kumar
T
T
Parry
J R W
JR
D018784:Abdominal Abscess / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D015746:Abdominal Pain / Q000209:etiology / Q000473:pathology; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004322:Drainage; D006119:Groin; D006552:Hernia, Inguinal / Q000175:diagnosis*; D006801:Humans; D008297:Male; D053018:Pyonephrosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D012421:Rupture; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents