An aortic abscess associated with psoas abscess: A case report

Abstract

In this article, we report a case in which a psoas abscess opened into the aneurysmatic abdominal aorta, and abscess formation was observed in the aortic lumen containing a stent. A 57-year-old male patient presented to the emergency department with a complaint of abdominal pain. During the abdominal examination of the patient, tenderness and defense were detected in the right lower quadrant. Contrast-enhanced computed tomography (CT) angiography of the abdominal aorta was ordered because the patient had a history of previous stenting and right lower quadrant deficiency. In the right iliopsoas muscle, there was an increase in size suggestive of abscess formation with air densities. The diameter of the ascending aorta was 44 mm. At the level of the descending thoracic aortic bifurcation, an aneurysmatic appearance was noted in a segment of approximately 140 mm extending to the proximities of both main iliac arteries, and USG showed air in the wall in the aneurysmatic section and mural wall thickening with thrombus. In this case, although the abscess eroded the aneurysmatic aortic wall, acute bleeding did not develop due to the presence of a stent. We wanted to share the rare image on computed tomography (massive air-fluid level around the stent in the aortic lumen), especially in our case with the medical literature.