骶髂关节结核合并髂腰肌、腹股沟冷脓肿1例

Clinical Analysis of One Case of Sacroiliac Joint Tuberculosis Complicated with Iliopsoas Muscle and Inguinal Cold Abscess

骶髂关节结核手术方案目前尚存争议,选择前路或后路手术并无具体指南。回顾分析1例骶髂关节结核合并髂腰肌、腹股沟冷脓肿形成的案例,患者,男,62岁,发现左侧腹股沟肿物2月就诊。经骨盆CT示:骶前间隙,左侧髂血管旁及腹股沟区不规则肿物伴骶管左侧、左侧髂骨骨质破坏,与左侧髂腰肌、梨状肌分界不清。手术选择前路置管联合后路开放,行病灶清除术,术程顺利,随访术后患者症状消失,病灶较前明显缩小,效果满意。

There is still controversy about the choice of surgical plan for sacroiliac joint tuberculosis.There is no specific guideline for the choice of anterior or posterior surgery.This article reviews one case of sacroiliac joint tuberculosis complicated with iliopsoas muscle and inguinal cold abscess and the related literature,in order to provide ideas for the diagnosis and treatment of sacroiliac joint tuberculosis.A patient,male,62 years old,found a left inguinal tumor and went to hospital 2 months later.Pelvic CT showed irregular masses in the anterior sacral space,left iliac vessels and inguinal area,with bone destruction of the left and left iliac bones of the sacral canal,and unclear demarcation with the left iliopsoas and piriformis muscles.Anterior catheterization combined with posterior opening was used for debridement of the lesions.The procedure was smooth,and the symptoms disappeared after follow-up.The lesions were significantly smaller than before,and the effect was satisfactory.