Journal Article

PSOAS hypertrophy mimicking retroperitoneal tumor in a child with abdominal pain

Wang, Shih-Min, Tsai, Ming-Che, Chen, Wen-Chau, Chuang, Chia-Chang, Yu, Chin-Yin

2004

Overview

Many radiographic signs of retroperitoneal lesions depend on indirect evidence such as displacement of the ureter or alternation of the psoas margin.1 The appearance of the psoas margin varies according to local pathologic conditions such as hematoma, abscess, and retroperitoneal tumors.2,3 However, obliteration of the psoas shadow is not a reliable indicator of a pathogenic process; some benign variants could mimic acute abdominal conditions.4 This patient's tumor-like lesion was brought to our attention only because of a delineated shadow on his KUB radiograph. [...]the cost and effectiveness of a CT scan for diagnosing an acute abdomen in a pediatric ED seems to be another challenging issue.6 More evidence is needed to establish a clinical algorithm that allows ED physicians to avoid a costly and time-consuming workup for a benign condition.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Abdomen / Abdomen, Acute - etiology / Adolescent / Children & youth / Diagnosis, Differential / Diarrhea - etiology / Emergency medical care / Emergency Treatment - economics / Emergency Treatment - methods / Emergency Treatment - standards / Family medical history / Humans / Hypertrophy / Lesions / Male / Mass Screening - economics / Mass Screening - methods / Mass Screening - standards / Medical diagnosis / Nausea - etiology / Pediatrics / Psoas Muscles - abnormalities / Psoas Muscles - diagnostic imaging / Psoas Muscles - pathology / Retroperitoneal Neoplasms - diagnosis / Tomography, Spiral Computed - economics / Tomography, Spiral Computed - standards / Urography