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Updated: Jun 18, 2026
06:02
Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
A case of primary psoas abscess presenting as buttock abscess
Jae Ho Yoo1, Eung Ha Kim, Hyun Seok Song
1Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Bucheon, Gyeonggi-do, 420-767, South Korea. yoojaeho@hotmail.com
Summary
Psoas abscess can rarely extend to form a buttock abscess. Prompt diagnosis and surgical drainage of both abscesses, along with antibiotics, led to a full recovery in a rare case.
Area of Science:
- Infectious Diseases
- Surgical Pathology
- Medical Imaging
Background:
- Psoas abscess is a collection of pus in the psoas muscle, often originating from spinal or abdominal infections.
- Buttock abscess is typically caused by local infections, making extrapelvic extension from a psoas abscess a rare presentation.
Observation:
- A 48-year-old woman presented with a painful, warm swelling in her buttock.
- Magnetic resonance imaging (MRI) identified a large subfascial abscess in the gluteal region, extending intra-abdominally to the psoas muscle.
Findings:
- The case demonstrated an unusual extrapelvic extension of a psoas abscess manifesting as a buttock abscess.
- Successful management involved separate surgical evacuation of both the psoas and buttock abscesses.
- Treatment included a 3-week course of empirical antibiotic therapy.
Implications:
- Psoas abscess should be considered in the differential diagnosis of buttock abscesses, especially in cases with atypical presentations.
- This case highlights the importance of advanced imaging like MRI for diagnosing complex, deep-seated infections.
- Effective management requires a multidisciplinary approach involving surgery and antibiotics to prevent recurrence.
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