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Updated: Aug 26, 2026
Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
[Psoas abscess in children based on a series of 18 cases]
Mohsen Belgith1, Mohamed Ben Brahim, Riadh Jouini
1Service de Chirurgie pédiatrique, Hôpital Fattouma Bourguiba, Monastir, Tunisie.
Insights
Psoas abscess in children is rare but treatable. Imaging, particularly ultrasound and CT, aids diagnosis, while percutaneous drainage offers a safe alternative to surgery for this condition.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Diagnostic Imaging
Context:
- Psoas abscess is an uncommon condition in pediatric patients, presenting diagnostic and etiological challenges.
- Early and accurate diagnosis is crucial for effective management and favorable outcomes in children.
Purpose:
- To describe the clinical characteristics, diagnostic approaches, and therapeutic strategies for pediatric psoas abscess.
- To highlight the role of imaging modalities in the diagnosis and management of this rare pediatric condition.
Summary:
- A series of 18 pediatric cases (11 months to 13 years) of psoas abscess were analyzed.
- Fever, abdominal pain, and lower limb impairment were common symptoms. Ultrasound and CT scans were instrumental in diagnosis, with Staphylococcus aureus being the most frequent pathogen.
- Treatment involved antibiotics and abscess drainage, with percutaneous methods (ultrasound- or CT-guided) proving effective and often preferable to surgery.
Impact:
- Percutaneous drainage guided by CT or ultrasound is a valuable and less invasive therapeutic option for pediatric psoas abscess.
- The generally favorable prognosis underscores the importance of timely diagnosis and appropriate management strategies.
Objective:
Psoas abscess is very rare in children and raises problems concerning the clinical and aetiological diagnosis. The authors describe the characteristics of this rare disease and emphasize the role of imaging in the diagnostic approach and therapeutic management.
Material And Method:
The authors report a series of 18 cases children aged 11 months to 13 years treated between 1988 and 2000 in the Monastir department of paediatric surgery. The time to diagnosis ranged from 4 days to 1 month. The clinical features comprised fever, abdominal pain and functional impairment of the homolateral lower limb in 17 cases.
Results:
Ultrasound was performed systematically and established the diagnosis in 17 cases. Computed tomography, performed in 13 cases, confirmed the diagnosis and demonstrated the aetiology in 3 cases. The microorganism was isolated in 16 cases (Staphylococcus aureus in 13 cases). An aetiology was identified in 4 cases: acute appendicitis, Potts disease, sacro-iliitis and perirenal abscess. Treatment comprised systematic antibiotic therapy combined with drainage of the abscess in 16 cases, which was performed surgically in 4 cases and percutaneously in 12 cases.
Conclusion:
The prognosis of psoas abscess in children is generally favourable. CT- or ultrasound-guided percutaneous drainage is a valuable alternative to surgery, which must be reserved for cases of failure of percutaneous drainage.
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