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A Rare Case Of Sigmoid Colon Perforation With Subsequent Psoas Abscess Collection With Extensive Involvement Of The Sartorius Muscle
  1. Ali Wadood,
  2. Abdulrahman Odeh,
  3. Khizer Rana,
  4. Shafquat Zaman
  1. Radiology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
  1. Correspondence to Dr Ali Wadood, ali.wadood{at}


A middle-aged man was admitted with worsening hip pain, fevers and reduced mobility. These symptoms were preceded by a mechanical fall but despite regular analgesia, symptoms did not resolve. His prior medical history included ischaemic heart disease, hypertension and hypercholesterolaemia. A trauma and orthopaedic review revealed a painful left hip with reduced range of motion. In addition, some mild tenderness in the left iliac fossa was noted. Blood tests revealed markedly raised inflammatory markers. Plain radiographs and ultrasound were normal. MRI scan found a massive left iliopsoas collection secondary to perforated diverticular disease of the sigmoid colon. The patient was managed with intravenous antibiotics and the collection was drained percutaneously. Approximately 500 mL of pus was aspirated. The patient made an excellent recovery with interval imaging showing a reduction in the collection size.

  • infection (gastroenterology)
  • general practice / family medicine
  • orthopaedics
  • interventional radiology
  • general surgery

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  • Contributors All authors have contributed to the production of this manuscript. KR is consultant radiologist who initially identified the case for write-up. KR was involved from the beginning of the case as he was involved in reporting the initial MRI scan that was performed on the patient. Through the case, KR was involved in modifying the content of the text and in assisting to look through the literature and interpreting images and linking the case figures to the necessary parts of the text. SZ was a member of the surgical team involved in managing the patient while in hospital. SZ’s role in the case involved ensuring that the history and examination findings of the case were accurate as he was closely involved in the patient's care, while also contributing to the text by producing the summary section of the paper and modifying content of the main bulk of the text. Both AW and AO were involved in planning the production of the manuscript in conjunction with SZ and the consultant KR in a series of meetings. AO and AW gathered information from the patient's case notes and the hospital information systems and used this information to produce a draft manuscript which was then subsequently modified in conjunction with senior colleagues KR and SZ. Literature review was performed by AO in conjunction with KR, while AW was involved in ensuring that references were produced from the literature review and the format of the text was in line with BMJ case reports submission policy.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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