Abstract
A 58-year-old male who underwent left total hip arthroplasty in 1988 for post-traumatic arthritis after an operatively-treated acetabular fracture presented with progressive left hip pain, lower extremity swelling, urinary urgency, constipation, and tenesmus (the feeling of needing to pass stool despite having an empty colon). Imaging demonstrated massive pseudotumor causing iliac vein compression and significant displacement of the rectum and bladder requiring decompression in combination with general surgery followed by revision hip arthroplasty four months later. This case highlights a unique constellation of symptoms due to pseudotumor after total hip arthroplasty, as well as the severity to which pseudotumor can progress, requiring staged decompression with general surgery before revision.