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Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
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Retroperitoneoscopic drainage of cryptogenic psoas abscess
Caterina Froiio1,2, Daniele Tiziano Bernardi2, Emanuele Asti3
1Surgery, Universita degli Studi di Milano, Milano, Italy.
BMJ Case Reports
|July 10, 2020
Summary
Psoas abscess, a serious infection, was successfully treated using a minimally invasive retroperitoneoscopic approach and antibiotics. This method offers a safe and effective option for treating cryptogenic psoas abscesses.
Area of Science:
- Infectious Diseases
- Minimally Invasive Surgery
Background:
- Psoas abscess is a rare, potentially life-threatening condition.
- Historically linked to spinal tuberculosis (Pott's disease), current prevalent causes include spondylodiscitis and Crohn's disease.
- Conventional treatments involve antibiotics, CT-guided, or surgical drainage.
Observation:
- A 67-year-old male with a history of pneumonia, sepsis, and trauma developed a psoas abscess.
- Blood cultures and pus identified Gram-positive *Streptococcus* sp.
- Transesophageal echocardiography suggested endocarditis as a potential sepsis source.
Findings:
- The psoas abscess was effectively treated with a minimally invasive retroperitoneoscopic approach and antibiotics.
- The patient experienced recurrent sepsis post-operatively, necessitating a change in antibiotic therapy.
- The retroperitoneoscopic approach demonstrated safety and efficacy in managing this cryptogenic psoas abscess.
Implications:
- Minimally invasive retroperitoneoscopic surgery is a viable and safe treatment for cryptogenic psoas abscess.
- Early identification of underlying causes, such as endocarditis, is crucial for comprehensive patient management.
- This case highlights the successful application of advanced surgical techniques for complex infections.
