化膿性腸腰筋炎の2例

Iliopsoas Abscess : Report of Two Cases

　抄録：近年比較的稀な疾患となってきている化膿性腸腰筋炎の2例を経験した．これらの症例ではこの疾患に特徴的な腸腰筋肢位は呈しておらず，診断にはCT・MRIなどの画像所見が有用であった．症例1は発熱を，症例2は発熱に加え鼡径部痛を主訴としていた．2症例ともいわゆる腸腰筋肢位は呈していなかった．血液検査では炎症反応の亢進を認めた．画像所見では症例1ではCTにて腸腰筋の腫大と筋内部の膿瘍形成を，症例2ではCTとMRIにて腸腰筋の腫大を認め，化膿性腸腰筋炎と診断した．症例1は観血的治療を，症例2は保存的治療を行い良好な結果を得た．

　We encountered 2 cases of iliopsoas abscess, which has recently become relatively rare, the position of the iliopsoas muscle which is characteristic of this disorder has not been present in recent cases.

　The CT and MRI imaging findings such as were useful in making the diagnosis. The chief complaint was fever in case 1, and fever and groin pain in case 2. The characteristic iliopsoas muscle position was not present in either of the cases. The blood studies showed an inflammatory reaction. The CT image in case 1 showed swelling of the iliopsoas muscle and an abscess with in the muscle. The CT and MRI images in case 2 showed only swelling of the iliopsoas muscle. Based on the physical findings, results of the blood studies, and imaging findings, we diagnosed iliopsoas abscess in both cases. Case 1 required surgery to achieve a cure. Case 2 recovered in response to conservative treatment alone.