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Iliopsoas abscess: A clinical dilemma — case report

Year 2022, Volume 6, Issue 4, 513 - 515, 01.04.2022


Iliopsoas abscess (IPA) is the accumulation of pus inside the iliopsoas muscle compartment. The early stages of its clinical presentation are often non-specific and therefore incidentally diagnosed with computed tomography. We describe the case of a 27-year-old man with a history of Crohn’s disease presenting with right-sided lower back pain radiating downwards to the lateral part of his thigh and exacerbated with hip movement. Examination of the patient showed a cachectic physique with a fixed flexion deformity at the right hip with a positive psoas sign. We further report the clinical dilemma on the diagnosis between Crohn’s disease and intestinal tuberculosis and the subsequent management of IPA secondary to Crohn’s disease. Our patient was managed with a loop ileostomy for bowel rest with continuous abscess draining and discharged after 3 months. After the reversal of ileostomy, the patient was satisfied with the overall outcomes. The clinical dilemma stems from the rising incidence of Crohn’s disease in Malaysia, as the clinical presentation of intestinal tuberculosis and Crohn’s disease is similar. Therefore, it is important for countries transitioning to higher income groups to be able to suspect and treat the condition accordingly.


  • 1. Mallick H, Thoufeeq MH, Rajendran TP. Iliopsoas abscess. Postgrad Med J. 2004;80:459-62. 10.1136/pgmj.2003.017665
  • 2. Yeh PH, Jaw WC, Wang TC, Yen TY. Evaluation of iliopsoas compartment disorders by computed tomography. Zhonghua Yi Xue Za Zhi(Taipei). 1995;55(2):172-9. PMID: 7750059.
  • 3. Matson M, Ahmad M, Power N. Diagnostic imaging. In: Norman W, O’Connell RP, McCaskie AW, eds. Bailey & Love’s Short practice of surgery. 27th ed. Portland: CRC press; 2018. Pp. 212.
  • 4. Jerome AL, Kuijper EJ, Prins JM etal. Tuberculin skin testing is useful in the screening for nontuberculous mycobacterial cervicofacial lymphadenitis in children. Clinical Infectious Disease. 2006;43:1547-51.
  • 5. Prabhu PR, Mayank J, Piyush B, Varghese J, Venkataraman J. Role of Colonoscopy in differentiating Intestinal tuberculosis from Crohn’s disease. Journal of Digestive Endoscopy. 2017;8(2): 72-7. 10.4103/jde.JDE_13_17
  • 6. Arzu NZ, Sezai T, Cengiz C. Evaluation of the GeneXpert MTB/RIF assay for rapid diagnosis of tuberculosis and detection of rifampin resistance in pulomonary and extrapulmonary specimens. J Clin Microbiol. 2011;49(12):4138-41. 10.1128/JCM.05434-11
  • 7. (2018). GHO | By category | Incidence - Data by country. [online] Available at:
  • 8. Hilmi I, Jaya F, Chua A, Wong CH, Singh H and Goh KL. A first study on the incidence and prevalence of IBD in Malaysia—results from the Kinta Valley IBD Epidemiology Study. J Crohns Colitis. 2015;9(5):404-9. 10.1093/ecco-jcc/jjv039
  • 9. Ng SC, Tang W, Ching JY, Wong M, Chung MC, Hui AJ, et al. Incidence and phenotype of inflammatory bowel disease based on results from the Asia-pacific Crohn’s and colitis epidemiology study. Gastroenterology. 2013;145(1):158-65. 10.1053/j.gastro.2013.04.007
  • 10. Hilmi I, Tan YM, Goh KL. Crohn’s disease in adults: observations in a multiracial Asian population. World J Gastroenterol. 2006;12(9):1435-8. 10.3748/wjg.v12.i9.1435
  • 11. Rheenen PF, Vijver EV, Fidler V. Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis. BMJ. 2010;341:c3369. 10.1136/bmj.c3369
  • 12. Larsson G, Shennoy KT, Ramasubramaniam R, Thayumanavan L, Balakumaran LK, Bjune GA, et al. High faecal calprotectin levels in intestinal tuberculosis are associated with granulomas in intestinal biopsies. Infect Dis (Lond). 2015;47(3):137-43. 10.3109/00365548.2014.974206
  • 13. Navaneethan U, Cherian JV, Prabhu R, Venkataraman J. Distinguishing Tuberculosis and Crohn’s Disease in developing countries: How certain can you be of the diagnosis? Saudi J Gastroenterol. 2009;15(2):142-4. 10.4103/1319-3767.49012
  • 14. Wu YF, Cheng MH, Yuan CT, Chen CN. Intestinal tuberculosis previously mistreated as Crohn’s disease and complicated with perforation: a case report and literature review. Springer plus. 2015;4:326. 10.1186/s40064-015-1129-x
  • 15. Hilmi I, Roslani AC, Goh KL. Management of IBD in Malaysia. IBD research. 2015;9(3):180-7.


Primary Language English
Subjects Surgery, Infectious Diseases, Gastroenterology and Hepatology, Pathology
Journal Section Case report

Yuki Julius NG WE YONG (Primary Author)
International Medical University

Muhammad IKBAAL This is me
Hospital Tuanku Ja'afar

Supporting Institution International Medical University and Hospital Tuanku Ja'afar
Project Number 001
Thanks Thank you for reviewing my case report
Publication Date April 1, 2022
Published in Issue Year 2022, Volume 6, Issue 4


Bibtex @case report { josam892361, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {}, publisher = {Fatih BAŞAK}, year = {2022}, volume = {6}, pages = {513 - 515}, doi = {10.28982/josam.892361}, title = {Iliopsoas abscess: A clinical dilemma — case report}, key = {cite}, author = {Ng We Yong, Yuki Julius and Ikbaal, Muhammad} }
APA Ng We Yong, Y. J. & Ikbaal, M. (2022). Iliopsoas abscess: A clinical dilemma — case report . Journal of Surgery and Medicine , 6 (4) , 513-515 . DOI: 10.28982/josam.892361
MLA Ng We Yong, Y. J. , Ikbaal, M. "Iliopsoas abscess: A clinical dilemma — case report" . Journal of Surgery and Medicine 6 (2022 ): 513-515 <>
Chicago Ng We Yong, Y. J. , Ikbaal, M. "Iliopsoas abscess: A clinical dilemma — case report". Journal of Surgery and Medicine 6 (2022 ): 513-515
RIS TY - JOUR T1 - Iliopsoas abscess: A clinical dilemma — case report AU - Yuki Julius Ng We Yong , Muhammad Ikbaal Y1 - 2022 PY - 2022 N1 - doi: 10.28982/josam.892361 DO - 10.28982/josam.892361 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 513 EP - 515 VL - 6 IS - 4 SN - -2602-2079 M3 - doi: 10.28982/josam.892361 UR - Y2 - 2022 ER -
EndNote %0 Journal of Surgery and Medicine Iliopsoas abscess: A clinical dilemma — case report %A Yuki Julius Ng We Yong , Muhammad Ikbaal %T Iliopsoas abscess: A clinical dilemma — case report %D 2022 %J Journal of Surgery and Medicine %P -2602-2079 %V 6 %N 4 %R doi: 10.28982/josam.892361 %U 10.28982/josam.892361
ISNAD Ng We Yong, Yuki Julius , Ikbaal, Muhammad . "Iliopsoas abscess: A clinical dilemma — case report". Journal of Surgery and Medicine 6 / 4 (April 2022): 513-515 .
AMA Ng We Yong Y. J. , Ikbaal M. Iliopsoas abscess: A clinical dilemma — case report. J Surg Med. 2022; 6(4): 513-515.
Vancouver Ng We Yong Y. J. , Ikbaal M. Iliopsoas abscess: A clinical dilemma — case report. Journal of Surgery and Medicine. 2022; 6(4): 513-515.
IEEE Y. J. Ng We Yong and M. Ikbaal , "Iliopsoas abscess: A clinical dilemma — case report", Journal of Surgery and Medicine, vol. 6, no. 4, pp. 513-515, Apr. 2022, doi:10.28982/josam.892361

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