# Abdominal Muscle Wall Abscess as a Rare Extra-abdominal Complication of Acute Diverticulitis: A Case Report and Review of Literature

## TL;DR

A rare case of an abdominal muscle wall abscess following acute diverticulitis is reported, emphasizing the need for early imaging and non-surgical treatment.

## Contribution

This case report highlights an uncommon extra-abdominal complication of diverticulitis and its successful non-surgical management.

## Key findings

- An abdominal muscle wall abscess occurred one month after sigmoid diverticulitis in a 48-year-old male.
- Ultrasound-guided drainage and antibiotics led to full recovery without surgery.
- Early imaging and individualized treatment are crucial for atypical diverticulitis presentations.

## Abstract

Diverticulitis may lead to intra-abdominal abscesses; however, extra-abdominal complications such as abdominal muscle wall abscesses are exceedingly rare. These abscesses can present weeks after conservative treatment, often with nonspecific symptoms that delay diagnosis. Understanding rare extension pathways of diverticular inflammation is essential for early recognition and management. We report a case of a 48-year-old male with grade III obesity who presented with a painful abdominal mass one month after an episode of sigmoid diverticulitis. Contrast-enhanced computed tomography revealed a loculated abscess in the anterior abdominal muscle wall. The patient was successfully managed with ultrasound-guided percutaneous drainage and targeted antibiotic therapy, achieving full recovery without surgical intervention. This case highlights the importance of early imaging and individualized, minimally invasive treatment in select patients. Clinicians should maintain a high index of suspicion for atypical presentations in unresolved diverticulitis.