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[Primary psoas abscess in children: 6 cases]
M Golli1, C Hoeffel, M Belguith
1Service de radiologie, hôpital universitaire Fattouma-Bourguiba, Monastir, Tunisie.
Insights
Pediatric psoas abscesses, though rare, can be effectively diagnosed and treated using advanced imaging like CT scans. CT-guided needle aspiration aids in identifying the abscess and guiding treatment, improving outcomes in children.
Area of Science:
- Pediatric Infectious Diseases
- Radiology
- Surgical Interventions
Background:
- Primary psoas abscess is an uncommon pediatric condition.
- Diagnosis and treatment can be enhanced by modern imaging modalities.
Purpose of the Study:
- To evaluate the role of imaging techniques in diagnosing and managing pediatric primary psoas abscess.
- To assess the effectiveness of CT-guided interventions.
Main Methods:
- Retrospective review of six pediatric patients (11 months to 10 years) with primary psoas abscess.
- Utilized X-rays, ultrasonography, and CT scans for diagnosis.
- Bacteriological studies via needle aspiration and treatment including antibiotics, percutaneous catheter drainage, and surgical drainage.
Main Results:
- CT scan accurately identified abscesses in all cases.
- Staphylococcus aureus was the most common pathogen (five cases).
- Successful treatment achieved with CT-guided percutaneous catheter drainage in two patients and surgical drainage in three.
Conclusions:
- CT-guided needle aspiration is valuable for diagnosing psoas abscesses in children.
- This technique can be extended for therapeutic purposes, including drainage.
Background:
Primary psoas abscess is very rare in childhood; its diagnosis and treatment can be improved by the use of recent imaging techniques.
Patients:
Six children, aged 11 months to 10 years (mean: 51 months) were admitted from January 1987 to 15 December 1993 because they suffered mainly from fever, lumbar pain and/or homolateral flexed hip. Examination showed a painful inguinal mass in five patients and hyperleucocytosis in all. X-rays showed disappearance of the external limit of psoas in two patients; ultrasonography showed enlarged psoas in all, associated with hypoechogenic mass in two and without echo in four patients. CT scan showed the abscess in all cases, permitting a needle aspiration for bacteriological studies: Staphycococcus aureus was present in five cases. Drainage of the abscess by CT-guided percutaneous catheter was performed in two patients. Surgical drainage was performed in three including one for whom percutaneous catheter drainage did not succeed. The two other patients were only given antibiotics.
Conclusion:
CT-guided needle aspiration to establish presence and nature of fluid collection is a well established technique that may be extended to treatment of psoas abscesses.