Thigh Abscess as an Uncommon Complication of Left-Sided Colonic Diverticulitis and the Pitfalls in Treatment: An Interesting Case Report

Abstract

Colonic diverticulitis is one of the common causes of surgical intervention in general surgical practice. In most cases, surgical intervention depends on the presence of a collection around the sigmoid colon, the feasibility of percutaneous drainage, and the patient's medical condition. The collection can occur in the thigh in rare cases due to a fistulous communication with the retroperitoneum and can track gravitationally along the psoas muscle into the thigh and leg without any discernible collection around the sigmoid colon or in the abdominal cavity. We came across a similar case of a 54-year-old man who presented with abdominal pain, and thigh and leg swelling. Left-sided colonic diverticulitis was seen without any discernible abdominal collection and a thigh abscess during the initial clinical presentation. He was treated with multiple drainages of the thigh abscess, ultimately followed by a Hartmann's procedure over a total hospital admission period of 52 days. Current literature does not throw much light on such a situation and makes it all the more critical to illustrate this case. We present this rare case and give a complete account of investigations, disease course, and the interventions done to throw light on the optimal management of such cases.