case_images: PMC6796597_01
case_images: Large, indurated mass on the right hip/flank spontaneously draining purulent fluid (patient is positioned in left lateral decubitus).
case_images: gr1.jpg
case_images: PMC6796597_01_gr1.jpg
case_images: fig0005
case_images: Upon physical exam there was found to be a large, indurated, fluctuant mass on the right hip/flank which was spontaneously draining pus from a small opening (Fig. 1).
case_images: Trans spatial, multiloculated fluid collection containing gas bubbles, extending through the right abdominal side wall involving the retroperitoneal space, abdominal/pelvic side wall musculature, and in the subcutaneous fat compatible with abscess.
case_images: gr2.jpg
case_images: PMC6796597_01_gr2.jpg
case_images: fig0010
case_images: Computed tomography (CT) demonstrated a trans-fascial, multi-loculated fluid collection containing gas bubbles, extending through the right abdominal sidewall involving the retroperitoneal space, abdominal/pelvic side wall musculature, and in the subcutaneous fat compatible with abscess (Fig. 2).
case_images: Wound defect after extensive debridement measured to be 19 cm x 20 cm x 20 cm. Clear muscle and soft tissue involvement noted.
case_images: gr3.jpg
case_images: PMC6796597_01_gr3.jpg
case_images: fig0015
case_images: The wound defect was measured to be 19 cm x 20 cm x 20 cm (Fig. 3).
case_images: Wound VAC applied to wound defect after drainage and debridement to prepare the wound for second look and closure.
case_images: gr4.jpg
case_images: PMC6796597_01_gr4.jpg
case_images: fig0020
case_images: Due to the large defect and grossly contaminated operative field, a negative pressure wound dressing, vacuum assisted closure dressing (VAC) was applied to prepare the wound for a secondary examination and delayed primary closure (Fig. 4).