2025, Vol. 7, Issue 2, Part F
Retroperitoneal appendicitis complicated by a psoas abscess: A case report of a 62-year-old female patient
Author(s): K Kamal, S Rihane, N Ouahabi Merroun, A Ettaoussi, M Bouali, A El Bakouri and K El Hattabi
Abstract: Background: Acute appendicitis may present atypically when the appendix is retroperitoneal, delaying diagnosis and increasing the risk of complications such as psoas abscess.
Case: A 62-year-old woman with hypertension and type 2 diabetes presented after one week of lumbar pain and fever, followed by acute confusion requiring ICU admission (GCS 10/15). Labs showed leukocytosis (13, 240/mm³) and markedly elevated CRP (492.1 mg/L). CT revealed extensive right pneumoretroperitoneum, a 43×35 mm right psoas fluid collection with air-fluid level, an inflamed retrocecal non-aerated appendix abutting the collection, thickened right peritoneal layers, multi-compartment effusions (peritoneal, retroperitoneal, right pleural, pericardial), and pneumomediastinum.
Management: The patient underwent retrograde appendectomy with evacuation of intra- and retroperitoneal pus, copious saline lavage, and drainage (Delbet blades and Salem tubes). Broad-spectrum antibiotics were initiated and later tailored to bacteriology.
Conclusion: Retroperitoneal appendicitis can masquerade as lumbar pathology and progress to psoas abscess. Prompt CT imaging and early surgical source control with appropriate antibiotics are critical to limit morbidity.
DOI: 10.22271/27081494.2025.v7.i2f.242Pages: 365-367 | Views: 221 | Downloads: 127Download Full Article: Click Here
How to cite this article:
K Kamal, S Rihane, N Ouahabi Merroun, A Ettaoussi, M Bouali, A El Bakouri, K El Hattabi.
Retroperitoneal appendicitis complicated by a psoas abscess: A case report of a 62-year-old female patient. Int J Case Rep Surg 2025;7(2):365-367. DOI:
10.22271/27081494.2025.v7.i2f.242
