Antalgic Flexion of the Lower Limb: An Unusual Presentation of Aortoiliac Infection with Psoas Muscle Abscess: Four Case Reports

• Published in: Vascular and endovascular surgery 2005-05, Vol.39 (3), p.287-292
• Main Authors: Melissano, Germano, Civilini, Efrem, Papa, Maurizio, Del Guercio, Raffaele, Chiesa, Roberto
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia; Anesthesia depending on type of surgery; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Aneurysm, False - surgery; Anti-Bacterial Agents - therapeutic use; Aorta, Abdominal - surgery; Biological and medical sciences; Blood and lymphatic vessels; Blood Vessel Prosthesis - microbiology; Cardiology. Vascular system; Debridement; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Drainage - methods; Humans; Iliac Artery - surgery; Intestinal Fistula - microbiology; Male; Medical sciences; Middle Aged; Prosthesis-Related Infections - diagnosis; Prosthesis-Related Infections - therapy; Psoas Abscess - microbiology; Psoas Abscess - therapy; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thoracic and cardiovascular surgery. Cardiopulmonary bypass; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
• ISSN: 1538-5744; 1938-9116
• DOI: 10.1177/153857440503900311

Psoas abscess with aortoiliac infection is rare. Patients are often symptomatic for a long time before the correct diagnosis is made. The authors report 4 cases in which the presenting symptom was an antalgic flexion of the left thigh. In 2 patients the cause was an aortic graft infection with enteric fistula; in the other 2, infection developed after transfemoral endovascular procedures. Open surgical treatment was performed in 3 cases and percutaneous drainage in 1. One surgical patient with a late diagnosis eventually died of sepsis; the other 3 are alive and well at mean follow-up of 14 months.