GENERAL PERITONITIS INDUCED BY RECTAL EXAMINATION - AN UNUSUAL COMPLICATION OF PRIMARY PSOAS ABSCESS

Primary psoas abscess is a relatively rare disease with highest incide nce in children and adolescents. It usually presents with fever, abdom inal pain and limp. Limping tends to incriminate musculoskeletal probl ems below the pelvis, but movement of the hip involves the psoas muscl e which is mostly retroperitoneal and intimately related to pelvic and intraperitoneal organs. Although the current tendency is to use abdom inal sonography, rectal examination is still a valuable step in clinic al examination, and may help to assess a pelvic mass or abscess. The f ollowing case report describes the elusive nature of psoas abscess and a rare occurrence of abscess rupture and peritonitis, immediately aft er rectal examination.