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[Primary iliopsoas abscess in children]
N Peled1, Y Versano, A Motovits
1Dept. of Radiology, Hasharon Hospital, Golda Medical Center, Petah Tikva.
Insights
Primary iliopsoas abscess, a rare childhood condition, often mimics other illnesses, leading to diagnostic delays. CT scans are crucial for accurate diagnosis and guiding drainage strategies.
Area of Science:
- Pediatric Infectious Diseases
- Abdominal Imaging
Background:
- Primary iliopsoas abscess is uncommon in children.
- It frequently presents with symptoms that mimic more prevalent pediatric conditions.
Observation:
- Three pediatric cases are presented where iliopsoas abscess was initially misdiagnosed.
- Two cases simulated acute appendicitis, resulting in unnecessary appendectomies.
- One case was misdiagnosed as sacroiliitis, leading to prolonged antibiotic treatment.
Findings:
- Ultrasound examinations were inconclusive in all three cases.
- Computed tomography (CT) scans successfully diagnosed the iliopsoas abscesses.
- CT imaging is identified as the preferred diagnostic modality.
Implications:
- Early and accurate diagnosis of pediatric iliopsoas abscess is critical to avoid delayed treatment and complications.
- CT scanning should be considered in pediatric patients with suspected iliopsoas abscess, especially when initial imaging is non-diagnostic.
- CT imaging aids in planning surgical or percutaneous drainage procedures.
Abstract:
Primary iliopsoas abscess is a relatively rare disease occurring mainly in children. Since it simulates more common conditions, delay in diagnosis is almost the rule. In 2 children it simulated acute appendicitis, but in both cases a normal appendix was removed. In a third child it led to the diagnosis of right sacroiliitis, and antibiotics were given for several weeks. Ultrasound examinations in all 3 failed to reveal the diagnosis, which was reached by CT scan. The latter is the method of choice for diagnosis and is of aid in deciding on the best route for drainage.