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外文期刊>Journal of Clinical and Diagnostic Research
>Right Psoas Abscess as a Consequence of Ruptured Appendix with Caecal Perforation and Presenting as Right Lumbar Swelling in a Toddler: A Rare Presentation of Appendicitis
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Right Psoas Abscess as a Consequence of Ruptured Appendix with Caecal Perforation and Presenting as Right Lumbar Swelling in a Toddler: A Rare Presentation of Appendicitis
Psoas Abscess (PA) is a very rare form of presentation of appendicular pathology, especially in a toddler. A three-year-old male child presentedto the casualty with complaint of right lumbar swelling for 14 days. There was no other signifcant history. On clinical examination, there was5×5 cm right lumbar swelling with a prominent bulge, which was non tender. USG and Contrast Enhanced Commuted Tomography (CECT)abdomen revealed PA which was drained by incision made on the bulge. There was feculent output noted from the incision and drainagesite the following day. Child underwent exploratory laparotomy and was found to have ruptured partially sloughed of appendix along withperforated caecum going deep to the psoas muscle which in turn was communicating via tract to the incision and drainage site. Residualappendectomy along with caecal repair was done. Diverting proximal loop ileostomy was made and an abdominal drain was placed.Postoperatively, the child recovered well and was discharged on postoperative day 5 with a functioning ileostomy and on full oral feeds. In thefollow-up distal cologram was done which revealed free ?ow of contrast along the entire colon up to rectum. The child has now been plannedfor stoma closure. Prompt diagnosis and prompt intervention was responsible for signifcantly reducing morbidity in the present case.
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