Abscess of the piriformis muscle in a 14-year old boy - a transrectal drainage method under transabdominal ultrasound guidance

Q4 Medicine
Katarzyna Szymak, M. Puliński, W. Choiński, Michał Szostawicki
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Abstract

Sciatica is a common reason for a medical consultation throughout the population. Piriformis pyomyositis is a rare cause of these symptoms. Its probable etiology is transient bacteraemia co-existing temporarily with a muscle injury.The aim of the study is to present a method for treating a piriformis muscle abscess with transabdominal ultrasound-guided transrectal drainage.A 14-year old boy, previously healthy, was admitted with symptoms of sciatica that appeared after intense physical exertion. Laboratory tests revealed elevated inflammatory parameters and positive blood culture results indicating Staphylococcus aureus. Antibiotic therapy was implemented. MRI of the small pelvis revealed a forming abscess of the right piriformis muscle. On day 6 of the antibiotic therapy, in the absence of improvement, it was decided to perform transrectal drainage under ultrasound guidance. Clinical improvement was achieved, and the inflammatory parameters decreased.Co-existence of sciatica symptoms and signs of an inflammatory condition should prompt the consideration of piriformis pyomyositis. The mainstay of treatment for piriformis pyomyositis is antibiotic therapy. The abscess formation reduces its effectiveness, which necessitates surgical intervention. The authors present the application of transrectal drainage under transabdominal ultrasound guidance as the shortest route of abscess evacuation.Transrectal drainage of piriformis pyomyositis is an effective and safe method. Concomitant use of ultrasound scans reduces the patient’s exposure to ionising radiation. However, the widespread use of this method requires more in-depth research and broadened experience.
14岁男孩梨状肌脓肿——经腹部超声引导下经直肠引流法
坐骨神经痛是全民就医的常见原因。梨状肌化脓性肌炎是引起这些症状的罕见原因。其可能的病因是暂时性菌血症和肌肉损伤并存。本研究的目的是提出一种经腹部超声引导经直肠引流治疗梨状肌脓肿的方法。一名14岁男孩此前健康,因剧烈体力消耗后出现坐骨神经痛症状入院。实验室检测显示炎症参数升高,血液培养结果呈阳性,表明金黄色葡萄球菌。实施了抗生素治疗。小骨盆的核磁共振成像显示右侧梨状肌脓肿正在形成。在抗生素治疗的第6天,在没有改善的情况下,决定在超声引导下进行经直肠引流。临床症状得到改善,炎症参数降低。坐骨神经痛症状和炎症症状的共同存在应促使考虑梨状肌化脓性肌炎。梨状肌化脓性肌炎的主要治疗方法是抗生素治疗。脓肿的形成降低了它的有效性,因此需要手术干预。作者介绍了经腹部超声引导下经直肠引流作为脓肿最短引流途径的应用。梨状肌化脓性肌炎经直肠引流是一种安全有效的治疗方法。同时使用超声波扫描可以减少患者暴露在电离辐射下的风险。然而,这种方法的广泛使用需要更深入的研究和更广泛的经验。
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来源期刊
Polish Annals of Medicine
Polish Annals of Medicine Medicine-Medicine (all)
CiteScore
0.40
自引率
0.00%
发文量
28
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