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.
Department of Urology, The Ipswich Hospital NHS Trust, Ipswich, United Kingdom. acraymond@doctors.org.uk
A C
AC
Raymond
M L
ML
Cutress
T
T
Sathesh-Kumar
J R W
JR
Parry
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