A rare case of iliopsoas abscess caused by a retained shrapnel from a blast injury.

BMJ Case Rep

Department of General Surgery, Monash Health, Clayton, Victoria, Australia.

Published: November 2021

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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8593738PMC
http://dx.doi.org/10.1136/bcr-2021-247100DOI Listing

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