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Rectal drainage: unusual evolution of a psoas abscess
V Ibañez1, C Gutierrez, J E Barrios
1Department of Pediatric Surgery, La Fe Children's Hospital, Valencia, Spain.
Summary
Two pediatric cases of primary psoas abscess were treated successfully with open drainage and antibiotics. This rare condition requires prompt intervention for favorable outcomes in children.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Urology
Background:
- Primary psoas abscess is a rare bacterial infection of the psoas muscle, particularly uncommon in pediatric patients.
- Early diagnosis and management are crucial to prevent complications such as sepsis and musculoskeletal damage.
Observation:
- Two pediatric patients, aged 15 months and 4 years, presented with primary psoas abscess.
- The second patient developed significant ureterohydronephrosis and spontaneous rectal drainage, highlighting the potential severity and natural course of the condition.
- Despite spontaneous drainage, complete resolution was not achieved, necessitating surgical intervention.
Findings:
- Both patients underwent open drainage and received systemic antibiotics, leading to a good clinical response.
- Patients were discharged on postoperative days 7 and 12, with no complications reported at a 5-month follow-up.
- This suggests that prompt surgical drainage combined with antibiotics is an effective treatment strategy.
Implications:
- This case series underscores the importance of considering primary psoas abscess in the differential diagnosis of pediatric abdominal pain and fever.
- Effective management involves timely surgical intervention and appropriate antibiotic therapy.
- Further research into the etiological factors and optimal treatment protocols for pediatric primary psoas abscess is warranted.
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