Necrotizing fasciitis from an iliopsoas muscle abscess caused by a toothpick: A case report and literature review.

International Journal of Surgery Case Reports
Wei-Quen TeeChih-Hsiung Kang

Abstract

Psoas muscle abscess is rare and can become more complicated to treat after they have progressed to necrotizing fasciitis. The data of secondary psoas muscle abscess cause by ingested toothpick are limited in the literature. We have done an extensive literature review and found a number of 8 cases (including our new case) of ingested toothpicks causing iliopsoas muscle abscess. We present a 70-year-old man with unremarkable medical history experienced left flank pain for several days with radiated to left thigh and unable to walk. He initially exhibited drowsiness at emergency department with fever and chillness. Computed tomography showed iliopsoas abscess and necrotizing fasciitis. This patient received emergent surgical debridement and a toothpick was found lodged in the deep portion of the left psoas muscle. He was tolerated to the treatment and discharged on 58 days after the operation. A review of the literature revealed only eight reported cases since 1946 (including ours) of ingested toothpicks migrating into the iliopsoas muscle and causing abscess formation or necrotizing fasciitis. Three of the cases did not exhibit gut perforation, possibly because of self-healing of the wound. Gastrointestinal symptoms are not alwa...Continue Reading

References

Aug 1, 1992·The Australian and New Zealand Journal of Surgery·B D Archer, I A Campbell
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Nov 26, 2010·The American Journal of the Medical Sciences·I-Hsin LeeDavid Hung-Tsang Yen
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Oct 21, 2018·International Journal of Surgery·Riaz A AghaUNKNOWN SCARE Group
Nov 13, 2018·Journal of Bone and Joint Infection·Markus RuppVolker Alt

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