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Psoas abscesses complicating colonic disease: imaging and therapy
D N Lobo1, W K Dunn, S Y Iftikhar
1Department of Surgery, University Hospital, Nottingham.
Annals of the Royal College of Surgeons of England
|April 21, 1999
Summary
Psoas abscesses are often linked to gastrointestinal issues, not just spinal tuberculosis. Effective treatment involves bowel resection, debridement, drainage, and antibiotics for better patient outcomes.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Infectious Disease
Background:
- Psoas abscesses are traditionally associated with spinal tuberculosis.
- Contemporary surgical practice increasingly identifies gastrointestinal disease as a primary cause.
Observation:
- A retrospective case note study analyzed patients treated for psoas abscess over two years.
- Seven patients presented with pyrexia, psoas spasm, a tender mass, and leukocytosis.
- Diagnostic imaging included abdominal radiographs, CT scans, MRI, and ultrasound.
Findings:
- Common etiological factors included Crohn's disease (3), appendicitis (2), sigmoid diverticulitis (1), and metastatic colorectal carcinoma (1).
- Surgical management typically involved transabdominal bowel resection, retroperitoneal debridement, and external abscess drainage.
- One patient underwent percutaneous drainage, and two required multiple surgical explorations for complications.
Implications:
- Psoas abscesses complicating gastrointestinal disease necessitate bowel resection, thorough debridement, drainage, and antibiotics.
- Defunctioning stomas may be required in some cases.
- A multidisciplinary approach is crucial, as psoas abscesses can extend to involve bone and joints.