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A rare case of iliopsoas abscess caused by a retained shrapnel from a blast injury
  1. Jonathan Tiong1,2,
  2. Katherine Grant2 and
  3. Andrew Gray2
  1. 1Department of Clinical Surgery, The University of Edinburgh, Edinburgh, Edinburgh, UK
  2. 2Department of General Surgery, Monash Health, Clayton, Victoria, Australia
  1. Correspondence to Dr Jonathan Tiong; jonathan.tiongyw{at}gmail.com

Abstract

Iliopsoas abscesses (IPA) are uncommon, with an associated mortality rate of up to 20%. We describe the case of a 55-year-old man war veteran who presented with an unusual cause of IPA secondary to retained foreign body (FB). His initial trauma 30 years before was a result of a blast injury with shrapnel penetration suffered after inadvertently driving over a landmine as an ambulance driver in a conflict region. A CT scan was performed, revealing a 13 mmx8 mm radio-opaque FB within the right psoas at the level of the fifth lumbar vertebra with a surrounding collection. Subsequent open surgical exploration removed two gravel fragments. Given the knowledge of a traumatic blast injury with retained FB and repeated episodes of sepsis, surgical exploration is warranted. To our knowledge, this is the first case of recurrent IPA secondary to a retained FB from a historical trauma.

  • general surgery
  • trauma

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Footnotes

  • Contributors JT was involved in planning, writing and editing the manuscript. KG was involved in planning the manuscript. AG was involved in supervising the case and editing the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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