ABSTRACT
We present a case of a postpartum female with iliopsoas fasciitis in the puerperium.
Two days after a spontaneous vaginal delivery at 38 weeks without any complications,
the patient complained of pain in the left thigh and hip, associated with a temperature
of 38°C. Consequently, she could not walk 4 days after delivery and her body temperature
had increased to 39°C. Extreme left flank pain and tenderness in the left pelvic wall
were prominent, whereas the tenderness in the pelvis was moderate. Magnetic resonance
imaging led us to diagnose iliopsoas fasciitis. This was complicated by sepsis but
improved after a protracted antibiotic treatment without any surgical intervention.
A literature review revealed that serious complications, including sepsis or permanent
functional disturbance, could arise although retroperitoneal fasciitis and/or abscesses
are very rare after vaginal delivery. Iliopsoas fasciitis could be considered when
patients complain of extreme pain in the pelvic wall, sacroiliac joint region, or
thigh-symptoms that are uncommon in uncomplicated endometritis.
KEYWORDS
Puerperal fever - retroperitoneal fasciitis - MRI
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Kotaro FukushimaM.D. Ph.D.
Maternity and Perinatal Care Unit, Kyushu University Hospital, Kyushu University
3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan