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The management of psoas abscess
1Queen Elizabeth Hospital, Kota Kinabalu, Sabah.
The Medical Journal of Malaysia
|September 1, 2000
Summary
Psoas abscess management was reviewed in 9 patients. Diagnosis utilized ultrasonography and CT scans, with extraperitoneal drainage. Tuberculosis was identified in some cases, responding to chemotherapy, but other infections led to mortality.
Area of Science:
- Medical Imaging
- Infectious Diseases
- Surgical Management
Background:
- Psoas abscesses present with varied symptoms, often including back pain and palpable masses.
- Diagnostic challenges exist, particularly in differentiating causes and identifying associated conditions like tuberculosis or perinephric abscesses.
Purpose of the Study:
- To investigate the clinical presentation and management strategies for psoas abscesses.
- To evaluate the effectiveness of diagnostic imaging and surgical interventions.
- To identify factors influencing patient outcomes.
Main Methods:
- Prospective and retrospective study of 9 patients with psoas abscess.
- Diagnostic imaging included ultrasonography (all patients) and CT scans (5 patients).
- Management involved extraperitoneal drainage; biopsies were performed in 2 patients.
Main Results:
- Ultrasonography and CT scans were effective in diagnosing psoas abscesses.
- Tuberculosis was identified in some cases, with positive response to anti-tuberculosis chemotherapy.
- A perinephric abscess caused by Pseudomonas led to mortality in one patient, alongside two others from multiorgan failure.
Conclusions:
- Early diagnosis of psoas abscess is crucial, with ultrasonography and CT being valuable tools.
- While tuberculosis is a treatable cause, other infections pose significant mortality risks.
- Multiorgan failure remains a critical complication impacting patient survival.