Atypical Presentation of Pelvic Abscess: A Case Report

Noaman, Haitham; Fouad, Ammar

doi:10.33091/amj.2022.176313

	Atypical Presentation of Pelvic Abscess: A Case Report
Al- Anbar Medical Journal
Article 8, Volume 18, Issue 2, 2022, Pages 86-89 PDF (685.95 K)
Document Type: Case reports
DOI: 10.33091/amj.2022.176313
Authors
Haitham Noaman^* ¹; Ammar Fouad²
¹Department of Medicine/Internal Medicine, College of Medicine, University of Anbar, Ramadi, Anbar, Iraq
²Department of Surgery/General Surgery, AL-Yarmouk Teaching Hospital, Baghdad, Iraq
Abstract
An abscess is a common disease worldwide and its diagnosis is usually straightforward. However, pelvic abscess is rarely seen in daily clinical practice. Besides, it is a challenge for the surgeon to diagnose abscesses in unusual location, including the pelvis. A 41-year-old housewife lady had a history of poorly controlled insulin-dependent diabetes mellitus with recurrent vaginitis, cervicitis, and recurrent urinary tract infection. She presented with bilateral hip joint pain and limitation in her movement, with diabetic ketoacidosis. She was admitted to the hospital for the treatment of diabetic ketoacidosis. A physical examination revealed a high-grade fever, unwell, and there is a pelvic mass. Laboratory tests showed leukocytosis and a low hemoglobin level. Ultrasonography and computerized tomography revealed a 5 × 5 pelvic mass, which was located anterior to the bladder, with a high suspicion of an abscess formation. The patient was admitted to the surgical ward and drainage of the abscess under general anesthesia with antibiotic cover was performed. The patient was discharged two weeks postoperatively with an improvement in all presenting features. Bilateral insidious hip joint pain with limitation of movement should orient the clinician to a pelvic abscess as one of the differential diagnoses of these symptoms.
Keywords
Pelvic Abscess; Ketoacidosis; surgery; Case report

References
[1] S. A. Damer, “Pelvic Abscess with Presentation as Inability to Ambulate,” Spartan Med. Res. J., vol. 2, no. 2, 2018. [2] C. Korownyk and G. M. Allan, “Evidence-based approach to abscess management,” Can. Fam. Physician, vol. 53, no. 10, pp. 1680–1684, 2007. [3] N. Zhao, Q. Li, J. Cui, Z. Yang, and T. Peng, “CT-guided special approaches of drainage for intraabdominal and pelvic abscesses: One single center’s experience and review of literature,” Medicine (Baltimore)., vol. 97, no. 42, 2018. [4] S.-H. Jeong et al., “Clinical features of intra-abdominal abscess and intestinal free-wall perforation in Korean patients with Crohn’s disease: results from the CONNECT study,” J. Clin. Med., vol. 10, no. 1, p. 116, 2020. [5] S. C. Mansour et al., “Bacterial abscess formation is controlled by the stringent stress response and can be targeted therapeutically,” EBioMedicine, vol. 12, pp. 219–226, 2016. [6] T. Pusiol, D. Morichetti, C. Pedrazzani, and F. Ricci, “Abdominal-pelvic actinomycosis mimicking malignant neoplasm,” Infect. Dis. Obstet. Gynecol., vol. 2011, 2011. [7] H. Wang, X. Qu, X. Liu, L. Ding, and Y. Yue, “Female peritoneal tuberculosis with ascites, pelvic mass, or elevated CA 125 mimicking advanced ovarian cancer: A retrospective study of 26 cases,” J Coll Physicians Surg Pak, vol. 29, no. 6, pp. 588–589, 2019. [8] D. Akıncı, O. Ergun, Ç. Topel, T. Çiftçi, and O. Akhan, “Pelvic abscess drainage: outcome with factors affecting the clinical success,” Diagnostic Interv. Radiol., vol. 24, no. 3, p. 146, 2018. [9] S. Granberg, K. Gjelland, and E. Ekerhovd, “The management of pelvic abscess,” Best Pract. Res. Clin. Obstet. Gynaecol., vol. 23, no. 5, pp. 667–678, 2009. [10] H. Noaman, S. Rawaf, A. Majeed, and A.-M. Salmasi, “Hydatid cyst of the heart,” Angiology, vol. 68, no. 9, pp. 765–768, 2017. [11] R. M. Al-Ani, “Nasal Tuberculosis in a Teenage Female,” Indian J. Otolaryngol. Head Neck Surg., vol. 71, no. 3, pp. 2047–2049, 2019.
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