A rare case of iliopsoas abscess caused by a retained shrapnel from a blast injury

BMJ Case Rep. 2021 Nov 12;14(11):e247100. doi: 10.1136/bcr-2021-247100.


Iliopsoas abscesses (IPA) are uncommon, with an associated mortality rate of up to 20%. We describe the case of a 55-year-old man war veteran who presented with an unusual cause of IPA secondary to retained foreign body (FB). His initial trauma 30 years before was a result of a blast injury with shrapnel penetration suffered after inadvertently driving over a landmine as an ambulance driver in a conflict region. A CT scan was performed, revealing a 13 mmx8 mm radio-opaque FB within the right psoas at the level of the fifth lumbar vertebra with a surrounding collection. Subsequent open surgical exploration removed two gravel fragments. Given the knowledge of a traumatic blast injury with retained FB and repeated episodes of sepsis, surgical exploration is warranted. To our knowledge, this is the first case of recurrent IPA secondary to a retained FB from a historical trauma.

Keywords: general surgery; trauma.

Publication types

  • Case Reports

MeSH terms

  • Blast Injuries* / complications
  • Blast Injuries* / diagnostic imaging
  • Blast Injuries* / surgery
  • Foreign Bodies* / complications
  • Foreign Bodies* / diagnostic imaging
  • Foreign Bodies* / surgery
  • Humans
  • Male
  • Middle Aged
  • Psoas Abscess* / diagnostic imaging
  • Psoas Abscess* / etiology
  • Psoas Abscess* / surgery
  • Tomography, X-Ray Computed