Rapid pulmonary fistulization complicating a psoas abscess with intraoperative hypoxemia: a rare case report.

Introduction and importance: Psoas abscess is a relatively uncommon condition that can present with vague clinical features. Patients with this condition often present in different ways to different specialties leading to delays in diagnosis and management. Case presentation: The authors present a 47-year-old woman with complaint of vague abdominal pain, fever, and raised inflammatory markers who underwent CT examination. On CT, a collection was noted in the right iliac fossa that extended along the right retroperitoneum through the retrocrural space in the right lung base communicating with a cavitary pulmonary lesion with air-fluid level. The psoas abscess was drained. Clinical discussion: Our case presents a number of rare and intriguing features. Notably, the patient, who was immunocompetent, experienced a primary Staphylococcus infection that swiftly progressed to a sizable pulmonary abscess, a phenomenon uncommon in such hosts. The rarity further extends to the source of infection, originating abdominally but culminating in thoracic complications through contiguous spread from a retroperitoneal site. Despite the potential severity, the patient's outcome was remarkably positive. Conclusion: This case underscores the potential rapidity of pulmonary involvement in psoas abscesses, emphasizing the need for heightened awareness and consideration of respiratory signs during preoperative assessments.

Case report: Total obstruction of the left main bronchus by a blood clot leads to pneumonectomy in a pregnant woman.

Introduction and importance: Airway obstruction resulting from blood clot formation is observed across various clinical scenarios and is often preceded by hemoptysis. This condition can significantly compromise respiratory function, potentially leading to life-threatening ventilatory distress. Case presentation: In this report, the authors present a case of acute airway obstruction associated with hemoptysis in an 18-week pregnant woman admitted to the emergency department for acute respiratory distress. Clinical and radiographic evidence strongly suggested the presence of an endobronchial blood clot causing focal airway obstruction. Diagnosis was confirmed through direct endoscopic evaluation. Clinical discussion: Initial attempts to remove the obstructing clot from the airway involved lavage, aspiration, and forceps extraction by using a bronchoscope. In cases in which these measures proved ineffective, other management strategies include rigid bronchoscopy, embolization, and surgical resection. Conclusion: Central airway obstruction is a critical condition caused by numerous factors such as tumours or blood clots. Treatment focuses on securing the airway, ensuring breathing, and using tools such as bronchoscopy for diagnosis and treatment. Surgery is considered a last resort when other methods are ineffective.