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[Psoas abscesses. Genesis, diagnosis, and therapy].

M Korenkov1, N Yücel, J M Schierholz

  • 1II.Chirurgischer Lehrstuhl der Universität zu Köln, Klinikum Cologne-Merheim. michael.korenkov@uni-koeln.de

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|July 29, 2003
PubMed
Summary

Computed tomography (CT) is crucial for diagnosing psoas abscesses. CT-guided drainage is preferred, but open retroperitoneal drainage remains a standard treatment option with no observed recurrence.

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Area of Science:

  • Medical Imaging
  • Surgical Procedures
  • Infectious Diseases

Background:

  • Psoas abscess is a rare condition with diverse causes and subtle symptoms, often leading to delayed diagnosis and complications.
  • Early diagnosis and effective treatment are essential to reduce patient morbidity and hospitalization duration.

Observation:

  • A retrospective analysis of ten psoas abscess cases (1996-2002) was conducted, with a literature review.
  • Computed tomography (CT) scanning proved decisive in diagnosing all psoas abscess cases.
  • The majority of abscesses were located on the right side, with primary and secondary etiologies identified.

Findings:

  • CT-guided drainage was performed in four patients, while open retroperitoneal drainage was used for five.
  • Common causative agents included Staphylococcus aureus, Bacteroides fragilis, and Escherichia coli.

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  • No postoperative mortality or abscess recurrence was observed in the study cohort.

    • Implications:

    • CT is the gold standard for psoas abscess diagnosis.
    • CT-guided drainage is the preferred initial treatment, with open retroperitoneal drainage as a reliable alternative.
    • Individualized postoperative antibiotic therapy is mandatory for successful outcomes.