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[Pediatric retroperitoneal iliac abscesses (author's transl)]
Insights
Retroperitoneal iliac abscesses in children are rare but serious. Prompt diagnosis and surgical intervention with antibiotics are crucial for effective treatment and improved outcomes.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Radiology
Context:
- Retroperitoneal iliac abscesses are uncommon in children under seven.
- Etiologies include sepsis, trauma, and appendicitis.
Purpose:
- To report on 11 cases of pediatric retroperitoneal iliac abscesses.
- To discuss causes, clinical signs, radiological findings, and treatment.
Summary:
- Common causes were sepsis, trauma, and appendicitis, with Staphylococcus and Streptococcus predominating.
- Clinical signs included fever, pain, limping, and scoliosis. Radiological findings showed psoas line obliteration and mass effect.
- Diagnosis utilized X-rays and ultrasound. Treatment involved surgical debridement, drainage, and antibiotics.
Impact:
- Highlights the importance of early diagnosis and multidisciplinary management for pediatric retroperitoneal iliac abscesses.
- Provides insights into the clinical presentation and diagnostic modalities for this rare condition.
Abstract:
11 cases of retroperitoneal iliac abscesses are reported in patients under seven years of age. Causes have been: sepsis in 2 cases, lumbar traumatism in 1, perforation of the iliac vein in 1, pararenal abscess in 1, following debridement of iliac adenitis in one child and by appendicular mass in another case. The etiology was unknown in the remaining cases. Gram positive germs such as Staphylococcus and Streptococcus predominated in the exudate cultures. The most important clinical manifestations have been: fever, painful mobilization of the psoas, pain in the iliac fossa, limping and antiallergic scoliosis. Among radiological findings obliteration of the psoas line, mass in the iliac fossa, ureteral displacement and vesical compression were the most outstanding. Breathing x-rays and echography were diagnostic procedures in our cases. Diagnosis and differential diagnosis are commented, together with treatment. Authors consider that surgical debridement and drainage and administration of antibiotics are the ideal therapeutical procedures in these processes.