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Updated: Aug 8, 2026

Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
The iliopsoas abscess: aetiology, therapy, and outcome
P K Baier1, G Arampatzis, A Imdahl
1Department of Visceral and General Surgery, University of Freiburg, Hugstetterstasse 55, 79104, Freiburg, Germany. peter.baier@uniklinikum.freiburg.de
Background And Aims:
The treatment strategy for patients with a retroperitonally localised abscess is controversial as it remains open which fluid collections should be drained by open access or by percutaneously inserted drainage.
Patients:
Therefore, the data of 40 consecutively treated patients with an iliopsoas abscess were analysed retrospectively.
Results:
Ten patients suffered from a primary abscess and ten from a post-operative abscess; further, in 20 patients, the aetiology of the abscesses were due to Crohn's disease, neoplasia, spondylitis or other relevant concomitant diseases. Eight of 40 patients were initially treated by image-guided percutaneous drainage (PD), the other by open access drainage. Six patients died (15%), all of them had been operated; 15 (37.5%) patients had a recurrence of their abscess and needed re-operation. Factors predicting a poor outcome were age, APACHE II score, bi-lateral abscesses and a post-operative or bony cause, but the bacteriological findings did not influence the outcome.
Conclusions:
We suggest an algorithm for treatment of iliopsoas abscesses depending on number and volume of the abscesses.
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