Related Experiment Video
Updated: Jan 7, 2026
Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
Iliopsoas Abscess: A Narrative Review
Romulo Armenta-Flores1, Diego Armenta-Villalobos1, Luis G Domínguez-Carrillo2
1Cardiovascular Medicine and Surgery División Clínica Nuestra Señora de la Luz Carmen Serdán, Irapuato, Guanajuato, México.
Background:
Iliopsoas abscess (IPA), a purulent collection in the iliopsoas compartment, is an infrequent disease that is insidious, easily overlooked, life-threatening, and rarely diagnosed early due to nonspecific symptoms and signs. The classic triad of fever, flank pain, and hip movement limitation is present in only 30% of patients. Delays in treatment are followed by increased morbidity and mortality. The microbial etiology of IPA is variable and depends on the geographical area. IPA can be primary or secondary due to the origin of the infectious focus. This review aims to outline the current stage of knowledge of IPA, to emphasize its precocious recognition, and to provide a precise diagnosis using modern imaging according to the hospital patients are seen at, in an effort to reduce the delay in the diagnosis and treatment of IPA.
Methods:
A comprehensive literature search was made from 1980 to December 2024 related to IPA published in English. Key words utilized were "iliopsoas abscess," "retroperitoneal infection," "psoas muscle disorder," "pyogenic psoas abscess," and "psoas abscess." A total of 247 papers were reviewed: 120 case reports, 33 short retrospective series of less than 15 patients, 20 large series with more than 50 patients, and 7 reviews. Additionally, 72 observational studies, 2 systematic reviews, and 2 prospective studies were reviewed. The inclusion criteria encompassed original and review articles published in English.
Conclusion:
Since the description of IPA with isolated cases, then small series, and recently large retrospective reviews from major hospitals worldwide, the diagnosis and treatment of IPA have improved. With modern imaging techniques (US, CAT scan, and MRI), the diagnosis of IPA has increased, but sequential use of the aforementioned methods is not standardized; besides, there is no uniform treatment for IPA so far. Current management of IPA entails broad-spectrum antibiotics plus percutaneous or surgical drainage.
Insights
Early recognition and diagnosis of iliopsoas abscess (IPA) are crucial for better outcomes. Modern imaging aids diagnosis, but standardized treatment protocols for this rare condition are still evolving.
Area of Science:
- Infectious Diseases
- Radiology
- Surgical Infections
Background:
- Iliopsoas abscess (IPA) is a rare, life-threatening retroperitoneal infection often diagnosed late due to nonspecific symptoms.
- The classic diagnostic triad is present in only 30% of patients, leading to delayed treatment and increased morbidity/mortality.
- Microbial etiology varies geographically, and IPA can be primary or secondary to other infections.
Purpose of the Study:
- To review the current knowledge on iliopsoas abscess (IPA).
- To emphasize the importance of early recognition and precise diagnosis of IPA.
- To reduce diagnostic and treatment delays for IPA using modern imaging techniques.
Main Methods:
- A comprehensive literature search was conducted from 1980 to December 2024, including case reports, series, reviews, and observational studies.
- Keywords used were "iliopsoas abscess," "retroperitoneal infection," "psoas muscle disorder," "pyogenic psoas abscess," and "psoas abscess."
- A total of 247 papers published in English were reviewed, with inclusion criteria encompassing original and review articles.
Main Results:
- Diagnosis of IPA has improved with modern imaging (ultrasound, CT, MRI).
- However, the sequential use of these imaging modalities is not standardized.
- There is currently no uniform treatment protocol for IPA.
Conclusions:
- Despite improved diagnostic capabilities, challenges in IPA management persist.
- Current management involves broad-spectrum antibiotics and drainage (percutaneous or surgical).
- Further standardization in diagnostic and treatment approaches is needed for optimal patient outcomes.
Related Concept Videos
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:27Acute Pyelonephritis I: Introduction
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:19Abdominal Regions and Quadrants
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four...