Department of Radiology
https://repository.maseno.ac.ke/handle/123456789/2911
2024-03-29T12:39:28ZRuptured Obturator Internus Muscle Abscess Causing Extensive Retroperitoneal Necrosis
https://repository.maseno.ac.ke/handle/123456789/4984
Ruptured Obturator Internus Muscle Abscess Causing Extensive Retroperitoneal Necrosis
Zablon Bett
Obturator internus muscle (OIM) abscess occurs rarely in adults. Accurate diagnosis is often hindered and delayed due to the
deep location of the abscess and the nonspecific clinical features. Even of rarer occurrence is rupture of the obturator internus
muscle abscess into the perirectal space and retroperitoneum causing extensive retroperitoneal necrotizing soft tissue
infection. We present a case of ruptured left OIM abscess, which initially presented with clinical features, which were
suspected as acute pancreatitis. Contrast-enhanced multidetector computed tomography (MDCT) of the abdomen and
pelvis revealed ruptured left OIM abscess with extensive fat stranding, fluid collections, and pockets of gas throughout the
perirectal space, perisigmoid space, and bilateral posterior pararenal and anterior pararenal spaces as well as thickening of
bilateral anterior renal fascia, posterior renal fascia, and lateral conal fascia. These CT findings were consistent with
extensive retroperitoneal necrotizing soft tissue infection secondary to ruptured left obturator internus muscle abscess.
Broad-spectrum antibiotics were instituted immediately, and the patient was urgently worked up for drainage of the
abscess and debridement of the necrotic material. However, the patient’s condition deteriorated quickly before the surgical
interventions were performed and slipped into septic shock. Emergency resuscitative measures were unsuccessful, and
unfortunately, the patient died. The case represents a rare pathology with an unusual presentation, which can be fatal if
diagnosis and treatment is delayed.
https://doi.org/10.1155/2020/8920178
2020-01-01T00:00:00ZAneurysmal dilatation of colon: A rare imaging presentation of colon cancer
https://repository.maseno.ac.ke/handle/123456789/4674
Aneurysmal dilatation of colon: A rare imaging presentation of colon cancer
Zablon Kipkemoi Bett
Aneurysmal dilatation of colon is a rare imaging feature of colon adenocarcinoma. Two
cases with massive aneurysmal dilatation of the colon secondary to moderately differenti ated adenocarcinomas are described. The 2 cases presented with asymmetric and progres sive abdominal distension with no obstructive symptoms. Contrast-enhanced computed
tomography of the abdomen and pelvis demonstrated marked aneurysmal dilatation of the
involved segments of the colon and circumferential mural thickening. Colonoscopy found
markedly dilated lumen in the involved segment of the colon. Histology of the biopsy spec imens taken during colonoscopy revealed moderately differentiated adenocarcinoma with
extensive infiltration of colon wall and damage of myenteric nerve plexus
2020-01-01T00:00:00ZXanthogranulomatous pyelonephritis presenting as giant gluteal abscess
https://repository.maseno.ac.ke/handle/123456789/4670
Xanthogranulomatous pyelonephritis presenting as giant gluteal abscess
Zablon Bett
Xanthogranulomatous pyelonephritis (XGP) is a rare chronic suppurative granulomatous infection of the kidney associated with renal obstruction and progressive renal parenchymal destruction. We present an unusual clinically occult case of extensive right XGP which presented clinically with discharging right gluteal sinus and swollen right posterolateral chest and abdominal walls extending caudally to right gluteus. Contrast enhanced computed tomography of the abdomen and pelvis revealed obstructing right renal calculi, severe hydronephrosis, renal destruction and large (20.7 × 10.2 × 14.7 cm) abscess extending caudally to right gluteus. Histopathology of the specimen was concluded as right xanthogranulomatous pyelonephritis. This case demonstrates how distant an insidious XGP can infiltrate. It also emphasizes the need to have a broad range of differential diagnoses including XGP when presented with a case of gluteal abscess and sinus. Contrast enhanced computed tomography plays a key role in evaluating the cause, extent and complications of XGP and is also useful in pretreatment planning.
Full content can be accessed through : https://doi.org/10.1016/j.radcr.2020.10.003
2020-01-01T00:00:00Z