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Journal articles on the topic 'Psoas rupture'

Author: Grafiati

Published: 5 June 2025

Last updated: 15 July 2025

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DAVIDSON, T., K. TUNG, OLIVIA CONSTANT, and L. EDWARDS. "Kidney Rupture and Psoas Abscess after ESWL." British Journal of Urology 68, no. 6 (1991): 657–58. http://dx.doi.org/10.1111/j.1464-410x.1991.tb15434.x.

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Kumar, Sanjana, and Jainendra K. Arora. "Neuroendocrine tumour of colon mimicking psoas abscess: an unusual presentation of an uncommon malignancy." International Surgery Journal 7, no. 5 (2020): 1681. http://dx.doi.org/10.18203/2349-2902.isj20201896.

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Psoas abscess is a rare disease usually arising due to a benign underlying pathology such as tuberculous disease of spine, Crohn’s disease and diverticulitis. But it can be an uncommon presentation of intra abdominal malignancy. Spontaneous rupture of colon cancer, combined with psoas abscess formation is very rare. Most of these cases have been reported in relation to carcinoma colon. Colon is an uncommon site for neuroendocrine tumors. 70-80% of these tumors are asymptomatic and are found incidentally at the time of surgery or on colonoscopy. Through this article we report a rare case of neuroendocrine tumor (NET) of colon in an elderly man presenting as psoas abscess associated with intestinal obstruction.

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Marco, Antonio Muñoz Pérez, Martín Alanís Naranjo José, Cesar Arana Martínez Julio, Samuel Montes Cruz Eliud, and Evodio Villegas Mayoral José. "Spontaneous Psoas Rupture Due to Anticoagulation in Mitral Valve Disease and Atrial Fibrillation." International Journal of Current Science Research and Review 05, no. 07 (2022): 2427–29. https://doi.org/10.5281/zenodo.6837238.

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Abstract : Iliopsoas hematoma is a rare complication in patients on anticoagulation therapy with coumarins. This clinical case presents a patient with a history of mitral stenosis, valvular prosthesis and atrial fibrillation who presented spontaneous rupture of the psoas due to excessive anticoagulation whit acenocoumarin.

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Yang, Jun-Young, June-Kyu Lee, Soo-Min Cha, and Yong-Bum Joo. "Psoas Abscess Caused by Spontaneous Rupture of Colon Cancer." Clinics in Orthopedic Surgery 3, no. 4 (2011): 342. http://dx.doi.org/10.4055/cios.2011.3.4.342.

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Tamaki, Hiromichi, Mitsumasa Kishimoto, and Masato Okada. "Clinical Images: Iliopsoas bursa rupture mimicking psoas muscle abscess." Arthritis & Rheumatism 62, no. 6 (2010): 1769. http://dx.doi.org/10.1002/art.27472.

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Vivian Ndidi Akagbue, Chidinma Wekhe, and Olukunmi Yetunde Ijeruh. "A case report of bilateral psoas abscess with co-existing gluteal abscess in Pott`s disease of the spine in a middle-aged woman in a Specialist Hospital." Magna Scientia Advanced Research and Reviews 12, no. 1 (2024): 195–201. http://dx.doi.org/10.30574/msarr.2024.12.1.0167.

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Psoas abscess (PA) is the buildup of suppurative fluid in the fascia surrounding the psoas/iliopsosas muscle, is a rare condition, with diagnostic difficulty. Pott`s disease also called spinal tuberculosis occurs due to extra pulmonary tuberculosis. Backpain, fever, weight loss, lump in the groin and limping are its main symptoms. Curable by administering antitubercular therapy and sensitive antimicrobials with analgesics for indicative relief. Surgical procedures can be carried out to eliminate the accrued fluid based on the inter individual degree of presentation. In this case report, we report a rare case of bilateral psoas abscess with co-existing gluteal abscess and Potts’s disease. A 48-year old female presented with complaints of backpain, limping, lump in the flank/buttock and fever of two weeks. Abdominopelvic computed tomography scan showed massive right iliopsoas muscle collection with extension into the ipsilateral gluteal region and subcutaneous tissue. Similar collection was seen in the left psoas muscle superiorly. The bone window of the lumbosacral spine showed the anterior wedged collapse of the vertebral bodies with gibbus deformity. The patient had spontaneous rupture of the gluteal collection and surgical drainage of the right iliopsoas and left psoas collection was done. Anti-Kochs therapy was commenced and patient is currently doing great. The introduction of computed tomography (CT) and magnetic resonance imaging (MRI) has greatly improved the diagnosis of psoas abscess with Pott`s disease or in its isolated forms.

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Tripathy, Dr Sangeeta. "Psoas Hematoma in a Child: Experience in a Tertiary Care Hospital." International Journal of Advanced Multidisciplinary Research and Studies 5, no. 1 (2025): 44–47. https://doi.org/10.62225/2583049x.2025.5.1.3615.

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Psoas hematoma presents with nonspecific symptoms. It is rare and usually occurs as a result of trauma, hematologic disease, during lumbar surgery often iatrogenic, rupture of aortic aneurysm etc. The incidence of spontaneous Psoas muscle hematoma has slowly increased as a result of anticoagulation use and use of antiplatelet agents. Is can present with non specific symptoms such as pain in abdomen, back and groin, or swelling, anemia, hemo dynamical instability and even leg paresis. CT Scan is the most important diagnostic test for rapid diagnosis of hematoma. CT Scan immediately diagnose the disease and thus helps in initiating early treatment. MRI is more sensitive than any other diagnostic modes but not easily available, expensive and with other restrictions for imaging. Psoas hematoma is easily overlooked disease especially in elderly patients. It often present atypically in elderly due to unusual presentation, comorbidity and cognitive impairment. Most hematomas resolve spontaneously without clinical complications if the hematoma is small and not compressing the surrounding important structures.

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Colic, Nikola, Dusan Saponjski, Milica Stojadinovic, Danilo Jeremic, Biljana Parapid, and Dragan Masulovic. "Vertebral erosion due to chronic rupture of aneurismatic abdominal aorta." Srpski arhiv za celokupno lekarstvo 147, no. 11-12 (2019): 762–64. http://dx.doi.org/10.2298/sarh190918121c.

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Introduction. Extremely rarely, the evolution of abdominal aortic aneurysm (AAA) includes the phase when extravasations of the blood from a ruptured aneurysm is contained by the surrounding tissue, referred to as chronic (contained) rupture of the AAA. Our aim was to call attention to this life-threatening condition, which is always challenging for diagnosis. Case outline. A 58-year-old man reported to the Emergency Center for significant abdominal pain. Ultrasound examination showed an infrarenal aneurysm of the abdominal aorta. A computed tomography scan of the thorax, abdomen, and pelvis with iodine contrast in arterial phase was performed. A free gas collection was observed between the liver and the anterior abdominal wall that is traced to a ruptured inflamed diverticulum on the transversal colon. Immediately distal to the branching sites of the renal arteries, the abdominal aorta extended forward and aneurismatically expanded. Posterior left, along the psoas muscle, a rupture of the aortic wall was seen, with an organized hematoma that accompanied the muscle. Between the hematoma and the aortic aneurysm, erosions of the anterior and lateral part of the vertebral bodies L2 and L3 were discovered. The patient underwent endovascular AAA repair (EVAR) and recovered well. Conclusion. Multidetector computed tomography angiography is a reliable, non-invasive, and necessary examination for localization and evaluation of the size of the AAA form, its chronic rupture, and complications such as vertebral body erosion.

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Sham, Minakshi, and Dasmit Singh. "Neonatal Ilio-Psoas Abscess: Report of Two Cases." Journal of Neonatal Surgery 3, no. 1 (2014): 4. http://dx.doi.org/10.47338/jns.v3.68.

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Ilio-psoas abscess (IPA) is rare in children and exceptional in the neonate. However, we recently managed two consecutive male neonates with right-sided IPA. The first baby was born two days after rupture of the membranes and had thick meconium-stained amniotic fluid. There was no such high risk factor in the second child. Diagnosis was made by ultrasonography in both the patients. Extraperitoneal surgical drainage was done and systemic antibiotics were given. Delay in presentation and uncontrolled sepsis, led to mortality in the first case. On the contrary, relatively early presentation, prompt drainage of the abscess and good response to higher antibiotics, lead to successful salvage of the second baby.

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González Lastre, Melba. "Spondylodiscitis Associated with a Psoas Abscess in the Course of Polymyositis. Case Report." Journal of Surgical Case Reports and Images 6, no. 3 (2023): 01–04. https://doi.org/10.31579/2690-1897/146.

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Introduction: Neck hematoma is a rare but potentially lifethreatening medical condition.Although spontaneous rupture of a parathyroid adenoma with extracapsular hemorrhage is rare, it may cause cervical and mediastinal hematoma, leading to potentially fatal consequences, it should be considered when a non-traumatic sudden neck swelling coexists with hypercalcemia. Case’s presentation: This report describes an atypical spontaneous rupture of an asymptomatic parathyroid adenoma in a 42-year-old woman who presented to the emergency room after the acute installation of an unpainful voluminous swelling in the right side of her neck, after eliminating a vascular emergency. Hemodynamically stable, the patient was treated conservatively with a period of observation in hospital, 1 month follow-up imaging with CT confirmed a regression of the half volume of the hemorrhagic lesion and the likely source of hemorrhage as a parathyroid nodule with significant vascularity. The diagnosis was confirmed on histopathological analysis after elective surgical exploration of the neck 3 months of a benign parathyroid adenoma. The patient made a full recovery with immediate normalization of her biochemistry post-operatively. Discussion: Spontaneous rupture of a cervical parathyroid adenoma with extracapsular hemorrhage should be considered when a non-traumatic sudden neck swelling coexists with hypercalcemia. The most appropriate treatment, in the absence of dyspnea or dysphagia, we believe that it is preferable to intervene surgically in a delayed manner. Conclusion: A high suspicion index is needed, particularly in post-menopausal women, to reach a diagnosis and allow optimal management. Since bleeding may recur, we suggest an independent indication for definitive parathyroidectomy surgery.

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Leeman, Marjolijn, Paul Burgers, Victor Brehm, and Jerome P. van Brussel. "Psoas abscess after bacille Calmette-Guérin instillations causing iliac artery contained rupture." Journal of Vascular Surgery 66, no. 4 (2017): 1236–38. http://dx.doi.org/10.1016/j.jvs.2017.02.038.

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Halman, Joanna, Klaudia Szydłowska, Łukasz Znaniecki, and Jacek Wojciechowski. "Questioning the Role of Psoas Measurements: Limited Predictive Value for Outcomes After Aortic Repair." Journal of Clinical Medicine 14, no. 12 (2025): 4227. https://doi.org/10.3390/jcm14124227.

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Background/Objectives: Abdominal aortic aneurysm (AAA) repair is a prophylactic intervention aimed at preventing rupture. As the population ages, surgical decision-making becomes increasingly complex, especially in older and frailer patients. Imaging biomarkers, such as psoas muscle area (PMA) and density (PMD), have been proposed as surrogates for frailty and potential predictors of surgical outcomes. However, their clinical utility remains uncertain. Methods: In this retrospective, single-center study, we evaluated 199 patients who underwent elective AAA repair between 2015 and 2019. Preoperative computed tomography angiography (CTA) was used to measure PMA and PMD at the level of the third lumbar vertebra. Lean psoas muscle area (LPMA) was calculated as the product of PMA and PMD. Sarcopenia was defined as the lowest tertile of each measurement. Outcomes were assessed using Fisher’s exact test, Kaplan–Meier survival analysis, and logistic regression. Results: No significant associations were found between PMA, PMD, or LPMA and early or late postoperative complications or mortality. Conclusions: Psoas muscle indices, measured on routine CTA scans, do not reliably predict postoperative outcomes in AAA patients. These findings suggest that further studies integrating broader clinical and functional assessments are needed to improve risk stratification and inform preoperative decision-making in this patient population.

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Theodoridis, Panagiotis G., Dimitrios N. Staramos, Nikolaos Ptochis, et al. "AAA Rupture and Psoas Hematoma due to Type II Endoleak from Inferior Mesenteric Artery “Unusual” Collaterals." Case Reports in Vascular Medicine 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/8607437.

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Although endovascular aneurysm repair (EVAR) in the abdominal aorta has reduced the perioperative mortality when compared with open repair, the need for reintervention after complications such as endoleak may be presented in up to 20% of the cases. Type II endoleak from branch vessels is often benign but can potentially be associated with progressive abdominal aortic aneurysm growth and sac expansion. We present a rare case of a patient who presented with sac expansion and psoas hematoma due to Type II endoleak from “unusual” collaterals of IMA and was treated successfully with endoleak microembolization and percutaneous decompression of the hematoma.

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Georgakarakos, Efstratios, and Symeon Dimitriadis. "Posterior Contained Rupture of an Abdominal Aortic Aneurysm Within the Psoas Muscle After Endovascular Repair." European Journal of Vascular and Endovascular Surgery 55, no. 4 (2018): 527. http://dx.doi.org/10.1016/j.ejvs.2017.11.014.

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Magfirah, Sulfia, Muhammad Sayuti, and Muhammad Ifani Syarkawi. "General Peritonitis ec Appendicitis Perforasi." GALENICAL : Jurnal Kedokteran dan Kesehatan Mahasiswa Malikussaleh 2, no. 6 (2023): 1. http://dx.doi.org/10.29103/jkkmm.v2i6.11167.

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Peritonitis adalah peradangan peritoneum yang merupakan keadaan darurat bedah akut yang mengancam jiwa. Peritonitis umumnya berkembang jika terjadi perforasi atau rupture organ hingga ke dalam rongga perut. Umumnya terjadinya peritonitis karena apendisitis perforasi dengan perkiraan prevalensi sekitar 43,1%. Pasien perempuan 21 tahun datang ke IGD Rumah Sakit Cut Meutia dengan keluhan nyeri perut bagian kanan bawah yang dirasakan terus-menerus sejak 2 hari sebelum masuk rumah sakit, nyeri memberat terutama apabila pasien berjalan dan batuk. Pemeriksaan fisik ditemukan kelainan pada abdomen berupa nyeri tekan dan nyeri lepas titik McBurney, Dunphy sign (+), Obturator sign (+), Psoas sign (+), Rovsing sign (-), dan defans muscular diseluruh lapang abdomen. Pemeriksaan penunjang didapatkan leukositosis (14.35 ribu/uL) dan peningkatan nitrofil segmen (82.63%). Pasien diberikan terapi simptomatis dan dilakukan tindakan pembedahan laparotomi appendectomy.

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Moriyama, Hideki, Keiichi Kimura, Shintaro Takago, Yoji Nishida, Mari Shimada, and Hirofumi Takemura. "Aortoduodenal Fistula After Endovascular Aortic Repair for an Inflammatory Abdominal Aortic Aneurysm: A Case Report." Vascular and Endovascular Surgery 55, no. 1 (2020): 95–99. http://dx.doi.org/10.1177/1538574420954307.

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Aortoenteric fistula after endovascular aortic repair for an abdominal aortic aneurysm is a rare but severe complication. Particularly, a case of inflammatory abdominal aortic aneurysm is extremely rare and there are only 3 reported cases. A 70-year-old man underwent endovascular aortic repair for impending rupture of an inflammatory abdominal aortic aneurysm and was medicated steroids for approximately 2 years. Four years after endovascular aortic repair, he developed endograft infection with an aortoduodenal fistula and a left psoas abscess. He underwent total endograft excision, debridement, in situ reconstruction of the aorta using prosthetic grafts with omental coverage, and digestive tract reconstruction to prevent leakage. Pseudomonas aeruginosa was detected in the infected aortic sac. The patient has not experienced recurrence of infection in the 35 months since his operation.

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Hariri, Omar, Omar Al Laham, and Ammar Mohammad. "Chronic contained ruptured abdominal aortic aneurysm with a rare presentation of lower limb neuropathic claudication: a report of two cases." Annals of Medicine & Surgery 85, no. 8 (2023): 4121–25. http://dx.doi.org/10.1097/ms9.0000000000000970.

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Introduction and importance: A vertebral body erosion that takes place due to a chronic contained rupture of an abdominal aortic aneurysm is an especially rare vascular pathology that comprises less than 5% of all causes of vertebral body erosion. Chronic contained rupture of an abdominal aortic aneurysms are primarily observed in hemodynamically stable patients whose chief complaint is lower limb neuropathic pain. This entity is extremely misleading and this results in delayed management of those patients increasing the morbidity and mortality rates. Case presentation: We present the two cases of 62-year-old and 65-year-old males. Preoperative radiology for each patient showed an infrarenal aortic aneurysm with a retroperitoneal hematoma in contact with the lumbar vertebral bodies and psoas muscle. The draped aorta sign was evident in both cases. Clinical discussion: A curative surgical intervention was accomplished for both patients, respectively. This was achieved through the removal of the existing hematomas that were compressing the vertebrae in addition to the complete isolation and resection of the respective abdominal aortic aneurysms along with thorough reconstruction of the aortoiliac spindles with patent synthetic grafts to ensure the patency of the preexisting vascular axis. Conclusion: A contained rupture of an abdominal aortic aneurysm is a rare occurring vascular pathology that manifests with nonspecific symptoms, such as femoral neuropathy and lower back pain proportionate to the degree of the level of erosion of the affected lumbar vertebrae. This will increase the possibility of misdiagnosis and delays in treatment. Such a life-threatening vascular emergency should be timely detected and treated to avoid its complications and patient mortality.

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Manasra, Mahmoud R., Roua E. Farah, Arein A. Abufara, Bara M. AbuIrayyeh, Rahaf E. Farah, and Mohammed A. Maraqa. "Road Traffic Accident Traumatic Vehicle Seat Belt Abdominal Wall Hernia." Case Reports in Surgery 2024 (February 16, 2024): 1–5. http://dx.doi.org/10.1155/2024/4408980.

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Traumatic abdominal wall hernia (TAWH) is a rare type of hernia with an incidence of about <1.5%, resulting from blunt abdominal trauma, which leads to an increase in the intra-abdominal pressure and rupture in the abdominal musculature and fascia with herniation of the abdominal organs into the defect. Most TAWH contained either a small bowel (69%) or a large bowel (36%), with 16% containing both. This condition is often not present as an isolated case, as 30% to 60% of the cases are accompanied by other intra-abdominal injuries. The typical manner of presentation is a tender subcutaneous swelling across the abdomen wall with overlaying bruising and ecchymosis. The radiological investigative modality of CT scan has the highest index of diagnosing accompanied intra-abdominal visceral injuries. We present a rare case of a 23-year-old male patient diagnosed with TAWH containing both small bowel and sigmoid colon associated with psoas hematoma caused by a seat belt postroad traffic accident (RTA).

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Hamard, Marion, Gaël Amzalag, Christoph D. Becker, and Pierre-Alexandre Poletti. "Asymptomatic Urolithiasis Complicated by Nephrocutaneous Fistula." Journal of Clinical Imaging Science 7 (February 20, 2017): 9. http://dx.doi.org/10.4103/jcis.jcis_83_16.

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Asymptomatic spontaneous nephrocutaneous fistula is a rare and severe complication of chronic urolithiasis. We report a case of 56-year-old woman with a nephrocutaneous fistula (NFC) which developed from a superinfected urinoma following calyceal rupture due to an obstructing calculus in the left ureter. The patient was clinically asymptomatic and came to the emergency department for a painless left flank fluctuating mass. This urinoma was superinfected, with a delayed development of renal abscesses and perirenal phlegmon found on contrast-enhanced uro-computed tomography (CT), responsible for left renal vein thrombophlebitis and left psoas abscess. Thereafter, a 99 mTc dimercaptosuccinic acid (DMSA) scintigraphy revealed a nonfunctional left kidney, leading to the decision of left nephrectomy. Chronic urolithiasis complications are rare and only few cases are reported in medical literature. A systematic medical approach helped selecting the best imaging modality to help diagnosis and treatment. Indeed, uro-CT scan and renal scintigraphy with 99 mTc-DMSA are the most sensitive imaging modalities to investigate morphological and functional urinary tract consequences of NFC, secondary to chronic urolithiasis.

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Nanavati, Aditya J., Sanjay Nagral, and Nitin Borle. "Retroperitoneal Perforation of the Appendix Presenting as a Right Thigh Abscess." Case Reports in Surgery 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/707191.

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A rare case of a retroperitoneal rupture of the appendix is being reported here. A 53-year-old male presented to us with a right sided thigh abscess. There were not any abdominal complaints at presentation. There was continuous discharge after incision and drainage from the thigh. Isolation, in culture, of an enteric bacterium from the pus prompted an evaluation of the gastrointestinal tract as a possible source. An MRI scan revealed fluid tracking from the right paracolic gutter over the psoas sheath and paraspinal muscle into the thigh. A CT scan revealed the perforation at the base of the appendix into the retroperitoneum. At laparotomy the above findings were confirmed. A segmental ileocaecal resection was done. The patient made an uneventful recovery. The absence of abdominal symptoms at presentation leads to delay in diagnosis in such cases. Nonresolving thigh and groin abscesses should lead to the evaluation of the gastrointestinal tract as origin. Diagnostic clues may also be provided by culture reports what as happened in this case.

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Mancini, Mariangela, Alex Anh Ly Nguyen, Alessandra Taverna, Paolo Beltrami, Filiberto Zattoni, and Fabrizio Dal Moro. "Successful Multidisciplinary Repair of Severe Bilateral Uretero-Enteric Stricture with Inflammatory Reaction Extending to the Left Iliac Artery, after Robotic Radical Cystectomy and Intracorporeal Ileal Neobladder." Current Oncology 29, no. 1 (2021): 155–62. http://dx.doi.org/10.3390/curroncol29010014.

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Uretero-enteric anastomotic strictures (UES) after robot-assisted radical cystectomy (RARC) represent the main cause of post-operative renal dysfunction. The gold standard for treatment of UES is open uretero-ileal reimplantation (UIR), which is often a challenging and complex procedure associated with significant morbidity. We report a challenging case of long severe bilateral UES (5 cm on the left side, 3 cm on the right side) after RARC in a 55 years old male patient who was previously treated in another institution and who came to our attention with kidney dysfunction and bilateral ureteral stents from the previous two years. Difficult multiple ureteral stent placement and substitutions had been previously performed in another hospital, with resulting urinary leakage. An open surgical procedure via an anterior transperitoneal approach was performed at our hospital, which took 10 h to complete, given the massive intestinal and periureteral adhesions, which required very meticulous dissection. A vascular surgeon was called to repair an accidental rupture that had occurred during the dissection of the external left iliac artery, involved in the extensive periureteral inflammatory process. Excision of a segment of the external iliac artery was accomplished, and an interposition graft using a reversed saphenous vein was performed. Bilateral ureteroneocystostomy followed, which required, on the left side, the interposition of a Casati-Boari flap harvested from the neobladder, and on the right side a neobladder-psoas-hitching procedure with intramucosal direct ureteral reimplantation. The patient recovered well and is currently in good health, as determined at his recent 24-month follow-up visit. No signs of relapse of the strictures or other complications were detected. Bilateral ureteral reimplantation after robotic radical cystectomy is a complex procedure that should be restricted to high-volume centers, where multidisciplinary teams are available, including urologists, endourologists, and general and vascular surgeons.

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Schoenhagen, Paul. "Comparison of images 1 month prior and at the time of admission show expansion of fluid collection along the anterior aspect of the left psoas muscle extending into the left pelvis; c/w contained hematoma/rupture." ASVIDE 5 (May 2018): 483. http://dx.doi.org/10.21037/asvide.2018.483.

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Cheung, Kin On, Tun Hing Lui, Catherine Wing Yan Tam, and Kwok Fai Godfrey Tam. "Ruptured mycotic iliac artery aneurysm presenting as infected psoas haematoma and mimicking psoas abscess." Radiology Case Reports 16, no. 12 (2021): 3776–82. http://dx.doi.org/10.1016/j.radcr.2021.09.014.

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Ng, Jian Hui, and Kenneth Wei Jian Heng. "Infected native aortic aneurysm with spondylodiscitis in an elderly septic man with back pain." BMJ Case Reports 14, no. 2 (2021): e235439. http://dx.doi.org/10.1136/bcr-2020-235439.

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Infected aortic aneurysm is a rare disease and is often overlooked as a source of infection in septic elderly patients. We present a case of a septic elderly man with a ruptured infected aortic aneurysm caused by Salmonella enteritidis. This condition was treated non-surgically with percutaneous endovascular aneurysm repair and antibiotics. The postoperative recovery was complicated a month later by spondylodiscitis and psoas abscess. He underwent radiologically guided drainage of the psoas abscess and was placed on lifelong suppressive antibiotics. We discuss the aetiology, treatment options and complications of this condition.

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Pennekamp, Dr Werner. "Permanent Lesion of the Lateral Femoral Cutaneous Nerve after Low-Volume Ethanol 96% Application on the Lumbar Sympathetic Chain." Pain Physician 4;16, no. 4;7 (2013): 391–97. http://dx.doi.org/10.36076/ppj.2013/16/391.

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Lumbar sympathetic blocks and chemical sympathectomies are used for the pain treatment of peripheral arterial occlusive disease or sympathetically maintained pain syndrome after nerve injury or complex regional pain syndrome (CRPS). A 30-year-old patient was referred to the pain department with all the clinical signs and symptoms of a CRPS of the right foot one and a half years after being surgically treated for rupture of the achilles tendon. An inpatient admission was necessary due to insufficient pain reduction upon the current treatment, strong allodynia in the medial distal right lower leg and decreased load-bearing capacity of the right foot. A computed tomography (CT)-guided lumbar sympathetic block at the right L3 (Bupivacaine 0.5%, 4 mL) led to a skin temperature increase from 21°C before block to > 34°C for about 5 hours after the intervention. The patient experienced significant pain relief, indicating sympathetically maintained pain. Thus, we performed a CT-guided lumbar sympathetic neurolysis at the same level (ethanol 96%, 2 mL) 5 days later, achieving again a significant skin temperature increase of the right foot and a slight reduction of his pain intensity from numeric rating scale (NRS) 7 prior to the intervention to NRS 4 after 8 hours (NRS, 0 = no pain, 10 = strongest pain imaginable). Eight months later a repeated inpatient admission was necessary due to considerable pain relapse and decreased loadbearing capacity of his right foot. A CT-guided lumbar sympathetic neurolysis was repeated at the L4 level on the right side and was successful, inducing a significant skin temperature increase. Despite a temporary irritation of the genitofemoral nerve 8 hours after the intervention, a delayed irritation of the lateral femoral cutaneous nerve occurred. This was a long-lasting lesion of the lateral femoral cutaneous nerve following a CT-guided chemical sympathectomy with a low-volume ethanol 96% application - a complication which has not been described in literature until now. This is probably caused by broad dissemination of the neurolytic agent along the psoas muscle despite a correct needle position and spread of contrast agent. The development of this nerve injury even after injection of a small volume of ethanol (2 mL) may be delayed. Key words: Complex regional pain syndrome, CRPS; sympathetically maintained pain syndrome, sympathectomy, neurolysis, lateral femoral cutaneous nerve, ethanol, complication, genitofemoral nerve

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Patel, Tapan, and Shivani Patel. "Enterocutaneous Fistula and Pneumoretroperitoneum due to Ruptured Psoas Abscess." Surgery Journal 07, no. 04 (2021): e286-e288. http://dx.doi.org/10.1055/s-0041-1735901.

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AbstractPsoas abscess is a rare condition that can present with vague clinical features. Its insidious onset can lead to a delay in diagnosis, resulting in high rates of complications and mortality. Here we describe a unique case of a patient presenting with enterocutaneous fistula and pneumoretroperitoneum due to ruptured psoas abscess.

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Chong, Kok-Chin, Ming-Jen Tsai, and Chih-Wei Hsu. "Ruptured Infected Aneurysm with a Gas-forming Psoas Abscess." Internal Medicine 51, no. 23 (2012): 3309–10. http://dx.doi.org/10.2169/internalmedicine.51.8530.

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A., Inufusa, Mikawa Y., Morita I., and Fujiwara T. "Ruptured abdominal aortic aneurysm associated with a psoas abscess." Archives of Orthopaedic and Trauma Surgery 122, no. 5 (2002): 306–7. http://dx.doi.org/10.1007/s00402-002-0395-6.

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C., Danny Darlington, and Fatima Shirly Anitha G. "Ruptured amoebic liver abscess with empyema thoracis - a case report." International Surgery Journal 4, no. 5 (2017): 1801. http://dx.doi.org/10.18203/2349-2902.isj20171643.

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Amoebiasis is one of the leading causes of deaths in the world. Though the most common manifestation is colitis, liver and lung involvement can occur. High index of suspicion is warranted to diagnose this condition. Apart from surgery and drainage, medical treatment is also important. We present a five year old boy with ruptured amoebic liver abscess with right empyema thoracis and right sided psoas abscess. The boy recovered well after timely percutaneous drainage and antibiotics. This case highlights the importance of serology and imaging in the diagnosis of this rare manifestation of a common etiology.

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Badhe, Padma Vikram, Dasari Ravi Kiran, and Harini Seshadri. "Pseudomyxoma retroperitonei masquerading as a psoas abscess." BMJ Case Reports 14, no. 6 (2021): e240299. http://dx.doi.org/10.1136/bcr-2020-240299.

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A 52-year-old woman was referred to our department with multiple discharging sinuses and swelling in the right flank and iliac region for the past year. Ultrasound revealed a large collection in the right psoas muscle with the sinus tract reaching up to the skin in the right iliac region. Despite repeated attempts at drainage, the collection continued to increase in size. CT was requested and revealed a large heterogeneous irregular collection in the right psoas with fistulous communication with the cecum and skin with the erosion of the overlying ilium. Because of lack of vertebral involvement, enhancing internal septations, non-visualisation of the appendix and feculent material admixed with mucinous discharge from the sinus, pseudomyxoma retroperitonei secondary to ruptured mucinous neoplasm of the appendix was suspected. Mucoid material at the local site was sent for histopathology, which confirmed our suspicion. Our treatment plan after ileostomy was cytoreductive surgery along with adjuvant radiotherapy (40 Gy in 20 fractions) with chemotherapy (5-fluorouracil and folinic acid given for 30 weeks, once a week). However, after ileostomy, the patient refused further treatment, citing financial reasons.

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Murad, Ciro Mancilha, Letícia Braga Ferreira, Rochelle Coppo Militão Rausch, and Cláudio Léo Gelape. "Late atrioventricular groove disruption presenting 7 years after mitral valve replacement: a case report." European Heart Journal - Case Reports 4, no. 3 (2020): 1–5. http://dx.doi.org/10.1093/ehjcr/ytaa091.

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Abstract Background Left ventricular rupture is the most feared complication in mitral valve surgery. Despite its low incidence, mortality rates can reach up to 75%. It usually presents on the operating room with a dissecting haematoma followed by massive bleeding after discontinuing cardiopulmomary bypass. However, cardiac rupture may be contained by adherent pericardium or scar tissue leading to chronic formation of a pseudoaneurysm (PSA). Case summary A 44-year-old man came to our institution with acute heart failure triggered by community-acquired pneumonia. He underwent mitral valve replacement with a mechanical prosthesis 7 years before and reported suffering from chronic worsening dyspnoea for 18 months. He underwent chest computed tomography scan and cardiac magnetic resonance imaging (CMRI), which showed two extensive left ventricular (LV) multilobulated PSAs. An operative approach was chosen and a tear was found on the posterior atrioventricular groove (AVG), communicating left ventricle with the PSA, which was closed with bovine pericardium patch. After weaning from cardiopulmonary bypass, he presented a diffuse life-threatening bleeding. The surgeons packed his chest with compresses before closing the sternum and he was operatively revised after 48 h. Post-operative CMRI showed that one of the PSAs remained connected with the LV. Despite of all, 1 year after hospital discharge, he remains asymptomatic without signs of heart failure. Discussion This case illustrates PSAs' potential to grow for a long period before causing symptoms, the complexity and risks of chronic AVG disruption surgery and the importance of careful annular manipulation and debridement as preventive measures in mitral valve surgery.

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Sugawara, Y., O. Sato, T. Miyata, et al. "Ruptured abdominal aorta secondary to psoas muscle abscess due to Klebsiella pneumoniae in an alcoholic." Journal of Infection 35, no. 2 (1997): 185–88. http://dx.doi.org/10.1016/s0163-4453(97)91875-2.

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Israrahmed, Amrin, Somesh Singh, Deb K. Boruah, and Rajanikant R. Yadav. "Glue Embolization of Adrenal Artery Pseudoaneurysm: Case Series with Review of Literature." Journal of Clinical Imaging Science 10 (April 16, 2020): 20. http://dx.doi.org/10.25259/jcis_23_2020.

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Mortality rates for pseudoaneurysm (PSA) rupture are high and immediate intervention in the form of embolization can be life saving for the patient. Adrenal artery PSAs are rare with scarce references in literature. These arteries are small in caliber and require modification of the cannulation techniques for endovascular access. In situations, where the distal artery cannot be cannulated or the ostium cannot be negotiated, and percutaneous direct needle puncture (PDNP) techniques can be used. We discuss two patients with adrenal artery PSA that presented to us and their successful embolization with N-butyl cyanoacrylate through endovascular and PDNP techniques along with relevant review of the literature.

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Sharon, Matty, Amir Sagy, Ittai Kurzon, Shmuel Marco, and Marcelo Rosensaft. "Assessment of seismic sources and capable faults through hierarchic tectonic criteria: implications for seismic hazard in the Levant." Natural Hazards and Earth System Sciences 20, no. 1 (2020): 125–48. http://dx.doi.org/10.5194/nhess-20-125-2020.

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Abstract. We present a methodology for mapping faults that constitute a potential hazard to structures, with an emphasis on ground shake hazards and on surface rupture nearby critical facilities such as dams and nuclear power plants. The methodology categorises faults by hierarchic seismo-tectonic criteria, which are designed according to the degree of certainty for recent activity and the accessibility of the information within a given region. First, the instrumental seismicity is statistically processed to obtain the gridded seismicity of the earthquake density and the seismic moment density parameters. Their spatial distribution reveals the zones of the seismic sources, within the examined period. We combine these results with geodetic and pre-instrumental slip rates, historical earthquake data, geological maps and aerial photography to define and categorise faults that are likely to generate significant earthquakes (M≥6.0). Their mapping is fundamental for seismo-tectonic modelling and for probabilistic seismic hazard analyses (PSHAs). In addition, for surface rupture hazard, we create a database and a map of Quaternary capable faults by developing criteria according to the regional stratigraphy and the tectonic configuration. The relationship between seismicity, slip dynamics and fault activity through time is an intrinsic result of our analysis that allows revealing the dynamic of the deformation in the region. The presented methodology expands the ability to differentiate between subgroups for planning or maintenance of different constructions or for research aims, and it can be applied in other regions.

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Woodall, M. Neil, and Robert F. Spetzler. "Microsurgical Treatment of Recurrent Conus Medullaris Arteriovenous Malformation: 2-Dimensional Operative Video." Operative Neurosurgery 16, no. 2 (2018): E44. http://dx.doi.org/10.1093/ons/opy180.

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Abstract Arteriovenous malformations (AVMs) involving the conus medullaris have a unique angioarchitecture due to their involvement of the arterial basket of the conus medullaris, which represents an arterial anastomotic network between the anterior spinal artery (ASA) and posterior spinal arteries (PSAs) at the level of the conus medullaris.1 These lesions consist of a combination of a true AVM nidus, which is usually extramedullary, and direct shunts between the ASA, PSAs, and the venous system. Patients may present with radiculopathy, myelopathy, or subarachnoid hemorrhage.2 A 40-yr-old woman status post T11-L1 laminoplasty for resection of a ruptured conus AVM 6 yr prior presented with routine follow-up angiography suggestive of an arteriovenous fistula. She was counseled regarding treatment options including endovascular embolization and microsurgical ligation or resection, and she elected to proceed with surgical treatment. At the time of surgery, a recurrent AVM was noted. A 2-dimensional intraoperative video illustrates the microsurgical treatment of her recurrent conus AVM. The patient recovered well postoperatively. Spinal angiography demonstrated complete obliteration of the lesion. The patient experienced transient urinary retention that was self-limited but otherwise was without any new neurological deficit. Due to the retrospective nature of this report, informed consent was not required. Video used with permission from Barrow Neurological Institute, all rights reserved.

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Wang, Cong-Yu, Yin Gu, Rui-Peng Yan, et al. "Severe Acute Pancreatitis Complicated by Multiple Intra-Abdominal Hemorrhages." Case Reports in Gastroenterology 19, no. 1 (2025): 79–88. https://doi.org/10.1159/000543626.

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Introduction: Intra-abdominal hemorrhage is a rare yet life-threatening complication of acute pancreatitis (AP), with a higher prevalence in cases of severe acute pancreatitis (SAP). This condition is primarily caused by vessel wall erosion and rupture of pseudoaneurysms (PSAs). However, SAP cases involving multiple sequential arterial hemorrhages are extremely rare. This condition is primarily brought on by the process of vessel wall degeneration and the development of PSAs. Nonetheless, SAP necessitating multiple episodes of arterial bleeding is very uncommon. Case Presentation: Here is the case history of a 31-year-old man already being treated for SAP. His condition was then complicated by massive, frequent intra-abdominal bleeding. The patient initially presented to the hospital with SAP. He was transferred to the intensive care unit for proper management. Massive intra-abdominal bleeds occurred on the 31st, 45th, and 60th days during hospitalization. The maximum blood loss was 1,500 mL. In each of the instances, digital subtraction angiography (DSA) embolization was carried out after the bleeding source had been verified. In order to manage SAP, continuous percutaneous drainage and staged pancreatic necrosectomy were undertaken for 6 months. No recurrence of intra-abdominal hemorrhage was detected. Infection of the abdominal cavity was properly controlled. The patient left the hospital in good condition. Conclusion: Spontaneous bleeding in the abdominal cavity is a severe and life-threatening complication of SAP. This is often caused by vessel wall erosion. In such cases, DSA plays a crucial role in diagnosis and management. Besides precisely locating the bleeding source, one can perform a much-needed embolization immediately. Consequently, the disease is under total control, and the patient is much more likely to survive.

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Murphy, E., M. Lopez, and A. Fallon. "104 SPONTANEOUS ILIOPSOAS TENDON RUPTURE AND PSOAS HAEMATOMA ON ASPIRIN MONOTHERAPY: A CASE REPORT." Age and Ageing 51, Supplement_3 (2022). http://dx.doi.org/10.1093/ageing/afac218.084.

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Abstract Background Spontaneous Iliopsoas Tendon (IPT) rupture is a rare condition, with a prevalence of 0.66%, occurring most commonly in athletes. Risk factors for non-athletic IPT rupture include age, female gender and steroid use. Psoas haematomas are associated with surgery, anticoagulation and coagulopathies. Only a handful of case reports have associated psoas haematoma with single antiplatelet use. We present the case of a patient who developed psoas tendon rupture and psoas haematoma. Methods A 77-year-old female presented with a four week history of declining mobility and left hip pain, without history of trauma. Past medical history included chronic lymphoedema and an NSTEMI, for which she was taking aspirin monotherapy. On examination, she had reduced power on left hip flexion and a tender anterior thigh, with normal sensation. CT showed asymmetric thickening of the left iliacus muscle and surrounding fat stranding. MRI demonstrated partial IPT tear with oedema extending into the iliacus muscle. Results After several weeks of rehabilitation, her mobility deteriorated again. A second CT was performed, which showed new expansion and fat stranding of the right iliopsoas muscle and tendon compatible with acute haemorrhage. Aspirin was held for four weeks, and she was discharged after completing rehabilitation. Her baseline mobility had disimproved and she required assistance and a frame on discharge. Conclusion IPT rupture and psoas haematoma are atypical causes of atraumatic hip pain in older adults. Nevertheless, they can cause significant disability. MRI is recommended as the gold standard for diagnosis. Treatment is commonly conservative, focused on physiotherapy and pain control to maintain mobility. While aspirin is not commonly associated with tendon rupture or haemorrhage, it is widely used in primary prevention of cardiovascular disease and due consideration should be given to stopping it following the occurrence of haemorrhage.

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Ray, Dhirendra, and Saket Nigam. "Tubercular Aortic Aneurysm with Rupture into Psoas Abscess." Mycobacterial Diseases 06, no. 01 (2016). http://dx.doi.org/10.4172/2161-1068.1000196.

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Asil, Serkan. "Endovascular Therapy of Aortic Rupture Secondary to a Psoas Abscess." Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology, 2023, 353–55. http://dx.doi.org/10.5543/tkda.2023.63458.

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Hafiani Y, ELAIASSI M, LAKRAFI A, et al. "Psoas hematomas in COVID 19 patients." International Journal of Anesthesiology and Pain Research, February 18, 2021, 01–05. http://dx.doi.org/10.36811/ijapr.2021.110004.

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The psoas hematoma Is a frequent complication of anticoagulant treatment and is the first diagnosis to Be made in any patient on anticoagulants with psoitis, the diagnoses Will Be made on the basis of ultrasound or CT examinassions and the treatment Most often consists of 'abstention. Keywords: Psoas hématome; COVID; Mechanical ventilation; Embolisation; Surgery; Epigastric artery rupture Introduction OVID-19 disease is a highly thrombogenic pathology requiring anticoagulation at a curative dose to prevent occurrence of pulmonary embolism or deep thrombosis, in addition to thromboembolic risk it has a component hemorrhagic manifested by bleeding at localizations multiple. Among these hemorrhages, muscle hematomas deep classified as severe bleeding. They are conventionally treated with conservative treatment with the discontinuation of drug and specific reversion, and in rare cases, by surgical evacuation. However, the spread or reappearance of bleeding, although the effect of anticoagulants has been canceled, should suggest additional etiology.

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Deng, Bo, Hai Nan Hong, Xin Bing Feng, Zheng Hua Hong, Guo Ping Cai, and Dun Hong. "Psoas hematoma as a rare complication of posterior lumbar interbody fusion: a case report." BMC Surgery 20, no. 1 (2020). http://dx.doi.org/10.1186/s12893-020-00942-1.

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Abstract Background Psoas hematoma rarely occurs in patients with spondylolisthesis who undergo posterior lumbar interbody fusion (PLIF) surgery. Case presentation Here we reported a case of a 57-year-old male patient diagnosed with spondylolisthesis who underwent PLIF at the local hospital. Seven days post-surgery, abdominal pain occurred, and the pain in the right lower limb gradually increased. The computerized tomography (CT) indicated a formation of hematoma around the psoas muscle. Digital-subtraction angiography (DSA) suggested a vascular injury, a rupture of the right segmental artery of the lumbar vertebral level 4. The patient then received DSA vascular embolization, after which the lower lumbar segmental artery active bleeding was stopped. One month after discharge, the abdominal hematoma was gradually absorbed, and the pain in the waist, leg, and abdomen disappeared. Conclusion Symptoms such as abdominal pain, abdominal distension, and exacerbation of lower limb pain, may suggest the occurrence of psoas hematoma after PLIF. DSA vascular embolization is suggested as the first treatment approach for this type of complication.

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Jutidamrongphan, Warissara, Boonprasit Kritpracha, Karl Sörelius, Keerati Hongsakul, and Ruedeekorn Suwannanon. "Features of infective native aortic aneurysms on computed tomography." Insights into Imaging 13, no. 1 (2022). http://dx.doi.org/10.1186/s13244-021-01135-x.

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Abstract Background Infective native aortic aneurysm (INAA) is a rare clinical diagnosis. The purpose of this study was to describe the CT findings of INAAs in detail. Methods This was a retrospective single-center study of INAA patients at a major referral hospital between 2005 and 2020. All images were reviewed according to a protocol consisting of aneurysm features, periaortic findings, and associated surrounding structures. Results One hundred and fourteen patients (mean age, 66 years [standard deviation, 11 years]; 91 men) with 132 aneurysms were included. The most common locations were infrarenal (50.8%), aortoiliac (15.2%), and juxtarenal (12.9%). The mean transaxial diameter was 6.2 cm. Most INAAs were saccular (87.9%) and multilobulated (91.7%). Calcified aortic plaque was present in 93.2% and within the aneurysm in 51.5%. INAA instability was classified as contained rupture (27.3%), impending rupture (26.5%), and free rupture (3.8%). Rapid expansion was demonstrated in 13 of 14 (92.9%) aneurysms with sequential CT studies. Periaortic inflammation was demonstrated as periaortic enhancement (94.7%), fat stranding (93.9%), soft-tissue mass (92.4%), and lymphadenopathy (62.1%). Surrounding involvement included psoas muscle (17.8%), spondylitis (11.4%), and perinephric region (2.8%). Twelve patients demonstrated thoracic and abdominal INAA complications: fistulas to the esophagus (20%), bronchus (16%), bowel (1.9%), and inferior vena cava (IVC) (0.9%). Conclusion The most common CT features of INAA were saccular aneurysm, multilobulation, and calcified plaques. The most frequent periaortic findings were enhancement, fat stranding, and soft-tissue mass. Surrounding involvement, including psoas muscle, IVC, gastrointestinal tract, and bronchi, was infrequent but may develop as critical INAA complications.

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Dnyanmote, Anuradha, Kuldip Patil, IAM Prashanth, Vidita Modi, and Vedanth Rao Tirmanwar. "A Rare Complication of Atypical Pancreatic Pseudocysts: A Case of Psoas Abscess with Renal Abscess." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2024. http://dx.doi.org/10.7860/jcdr/2024/69432.19606.

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Pancreatic pseudocysts can extend beyond the boundaries of the pancreas due to the enzymatic nature of the fluid they contain. However, the extension of a pseudocyst beyond the retroperitoneum, into the psoas muscle, and within the subcapsular space of the left kidney is extremely rare, with only a few documented cases in the medical literature. In this report, authors present a case of a 36-year-old male with chronic pancreatitis and atypical pseudocysts that were left untreated due to his negligence. Secondary infection led to the formation of a psoas abscess, perinephric abscess, and a renal abscess. Complications such as intracystic haemorrhage, infection, and rupture of a pseudocyst are uncommon and can be fatal, if treatment is delayed. Pseudocysts in atypical locations, complicated by a secondary infection, are extremely rare and must be timely and effectively managed.

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Wen, Ta-Jen, Yu-Te Su, Hung-Yen Ke, and Kuan-Cheng Lai. "A Man with Severe, Left Lower Quadrant Abdominal Pain." Clinical Practice and Cases in Emergency Medicine 7, no. 3 (2023). http://dx.doi.org/10.5811/cpcem.1601.

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Case presentation:&nbsp; An 84-year-old man presented to the emergency department with sudden, left lower quadrant cramping pain. Because critical hypotension was noted, point-of-care ultrasonography (POCUS) was performed immediately. The study revealed a pulsatile flow extravasating from the left common iliac artery into the left psoas muscle with hypoechoic para-aortic fluid collection.&nbsp;Discussion: Common iliac artery rupture is rare and has nonspecific clinical presentations. A quick disposition can be made with a combination of clinical manifestations and POCUS results.

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Ivanova, Patricija. "A case report of endovascular treatment of a fast-growing inflammatory abdominal aortic aneurysm in a patient with Staphylococcus aureus sepsis." Journal of Clinical Images and Medical Case Reports 5, no. 3 (2024). http://dx.doi.org/10.52768/2766-7820/2948.

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Abdominal Aortic Aneurysm (AAA) and its subsequent rupture is one of the life-threatening conditions. The most common type of arterial aneurysm, AAA, becomes significant at a diameter greater than 3 cm. The mean growth rate of an AAA is 2-3 mm per year, and surgical repair is usually recommended if the diameter exceeds 5.5 cm, in men and 5.0 to 5.2 cm, in women. Faster-growing aneurysms are more aggressive and have a greater risk of rupture. We report a case of a 64-year-old, comorbid male patient who was found to have a previously unknown, but a rapidly growing AAA, which grew from 6cm to 8 cm within just 3 weeks. He was admitted in the emergency department with complaints of worsening dyspnea even without exertion. Upon thorough diagnostic tests, the severity of the overall medical condition was determined by S. aureus sepsis, decompensation of cardiovascular disease, and secondary kidney injury due to septic shock. While receiving treatment for sepsis, a diagnostic CT imaging was done, which confirmed bilateral pneumonia and retroperitoneal abscess in m. psoas major mass, and an infrarenal abdominal aortic aneurysm, which was 6cm in diameter at the time of diagnosis. Another control CT of the lungs and abdomen was performed three weeks later, indicating the pneumonia was slowly resolving, while the aortic aneurysm increased in dynamic; the diameter was 8 cm with a penetrating exudation on the left side, m. psoas abscess was still observed, but decreasing. Because the AAA was very fast-growing, it greatly increased the risk of its rupture, therefore a decision was made to perform endovascular abdominal aortic aneurysm repair, despite the risk of stent infection, given the patients septic background. The goal of this case report is to highlight the rare case of a rapidly growing inflammatory aneurysm and its successful endovascular management. While it’s known that 5-10% of all AAA are inflammatory, cases of surgical treatment in the setting of sepsis are basically non-existent in the literature [1].

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Ibrahim, Abdulhakim, Elena Marchiori, Alexander Oberhuber, and Marco V. Usai. "Fatal Case of a Contained Ruptured of the Infrarenal Aorta due to Simultaneous Primary Aortocaval Fistula and Aortoenteric Fistula." Indian Journal of Surgery, August 22, 2021. http://dx.doi.org/10.1007/s12262-021-03071-y.

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AbstractWe report an extremely rare case of primary aortocaval fistula with simultaneous development of an aortoenteric fistula in a 68-year-old man. The patient developed under oral anticoagulation a spontaneous intracaval aortic rupture. An emergency intervention was performed with a covering of the fistula with an aorto-uniiliac stent graft and a femoro-femoral crossover bypass. One week later, the patient was transferred to our institution with the diagnosis of a psoas abscess and a suspected concomitant aortoenteric fistula. We performed a complete explantation of the endograft and implanted it after extensive debridement an aortobiiliac bypass, made of bovine pericardium. The postoperative course was complicated, first by bleeding from the left iliac anastomosis, and then by bleeding from the proximal aortic anastomosis. The entire graft was explanted and an axillo-femoral bypass was implanted. The patient then developed a multi-organ failure and died 3 months later. If possible, an extended surgical debridement and resection of all infected tissue with in situ reconstruction is the gold standard. However, with this therapy, there is still a high risk of reinfection. Long-term antibiotic management is mandatory.

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Maheshwari, Aditya V., Rajesh Malhotra, Deepak Kumar, and J. David Pitcher. "Rupture of the ilio-psoas tendon after a total hip arthroplasty: an unusual cause of radio-lucency of the lesser trochanter simulating a malignancy." Journal of Orthopaedic Surgery and Research 5, no. 1 (2010). http://dx.doi.org/10.1186/1749-799x-5-6.

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Hsu, Wei-Hsun, Chu-Hao Weng, Marcelo Chen, and Chih-Chiao Lee. "Necrotizing Fasciitis Extending to the Neck After Extracorporeal Shock Wave Lithotripsy: A Case Report." Iranian Journal of Radiology 19, no. 2 (2022). http://dx.doi.org/10.5812/iranjradiol-126548.

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Introduction: Minor complications have been reported following extracorporeal shock wave lithotripsy (ESWL), including renal colic, gross hematuria, urinary obstruction, and hematoma. Some rare major complications have been also reported, such as abscess formation, acute pancreatitis with abscess, and splenic rupture. Here, we present the computed tomographic (CT) findings of a patient with necrotizing fasciitis, along with abscess formation after ESWL, which rapidly invaded the neck, chest, and abdominal wall. Case Presentation: A 67-year-old woman presented with persistent cough, intermittent nausea, and progressive right flank pain for one month after ESWL, which was performed for a right upper ureteral stone, measuring 1.2 × 0.3 cm, with right hydronephrosis detected on abdominal X-ray and renal ultrasound. The initial abdominal CT scan showed perirenal and pararenal hematoma of the right kidney, extending to the right posterior pararenal space, right psoas muscle, and right paraspinal region. Empiric antibiotic treatment was prescribed for the patient. After one week of treatment, the follow-up CT scan showed perirenal and pararenal abscesses with necrotizing fasciitis, invading the posterior region up to the paraspinal region and then migrating upward to the chest wall, axillary, supra-clavicular, and infra-clavicular regions, and the neck. The abscess also caused downward damage to the abdominal wall. Four weeks after a surgical intervention, the inflammatory process almost resolved. Conclusion: Although the possibility of post-ESWL necrotizing fasciitis is acutely low, it is important to consider this fatal complication.

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Parillo, Marco, Federica Vaccarino, Bruno Beomonte Zobel, and Carlo C. Quattrocchi. "A Rare Case of Contained Chronic Rupture of Abdominal Aortic Aneurysm Associated With Vertebral Erosion: Pre- and Post-operative Findings on Computed Tomography and a Narrative Review." Vascular and Endovascular Surgery, June 10, 2022, 153857442211080. http://dx.doi.org/10.1177/15385744221108040.

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Contained chronic rupture of aortic aneurysm (CCR-AA) is a rare condition that can be associated with vertebral body erosion (VBE) and is often a diagnostic challenge; in fact, CCR-AAs are in general hemodynamically stable and the patients tend to present with a non-specific low-back pain syndrome secondary to vertebral involvement. Furthermore, the differential diagnosis of a retroperitoneal mass can be difficult on medical imaging. We discuss the case of a 79-years-old man, heavy smoker without history of cardiovascular diseases, admitted to the emergency department with signs of left lower limb ischemia. The patient was hemodynamically stable and the medical examination revealed a pulsatile abdominal mass. Doppler ultrasound showed the presence of aneurysmal dilatation of infra-renal abdominal aorta and chronic femoropopliteal occlusion on the left side. The subsequent computed tomography angiography (CTA) demonstrated a voluminous retroperitoneal mass continuous with the infra-renal aorta, which infiltrated the psoas muscles and caused vertebral bodies erosion of the anterior wall in L2, L3 and L4 suspected for CCR-AA or mycotic aortic aneurysm. Furthermore, the examination confirmed the occlusion of the peripheral arterial circulation of the left lower limb. The patient underwent a successful open replacement of the infra-renal abdominal aorta through aorto-aortic prosthetic graft insertion; the visualization during the surgical procedure of a posterior vessel wall opening in continuity with the eroded vertebral bodies associated with negative microbiological culture of the thrombotic material sample, led to the definitive diagnosis of CCR-AA. The post-operative CTA showed successful open vascular treatment. A bypass surgery of the left lower limb was then performed with positioning saphenous graft between femoral common artery and posterior tibial artery. The patient was finally discharged in good clinical conditions.

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Scheuermann, Alexis, Meredyth Berard, Shivani Jain, et al. "Abdominal Pseudoaneurysms in Patients With High-Grade Traumatic Injuries." American Surgeon™, May 5, 2023, 000313482311711. http://dx.doi.org/10.1177/00031348231171120.

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Utilization of CT scans in the work-up of trauma patients has led to increasing diagnosis of traumatic pseudoaneurysms (PSAs). While rare, PSAs have devastating consequences if ruptured. Evidence for the benefit of early detection of PSAs is lacking. The objective of this case series was to determine the incidence of solid organ PSAs after trauma. A retrospective chart review of patients with AAST grade 3-5 traumatic solid organ injuries was performed. 47 patients were identified with PSAs. PSAs were most common in the spleen. A CT finding of contrast blush or extravasation was found in 33 patients. 36 patients underwent embolization. 12 patients had an abdominal CTA prior to discharge. Re-admission was required for 3 patients. 1 patient presented with PSA rupture. During the study, there was no consistency in surveillance for PSAs. Future studies are needed to develop evidence-based practice guidelines for PSA surveillance in high risk populations.

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