Abscess, Psoas

Christina Marie Colosimo, DO, MS and Marwan Sheckley, MS, DO Reviewed 05/2023

BASICS

A collection of purulent fluid in the iliopsoas compartment; it has a high morbidity and mortality if not promptly diagnosed and treated.

DESCRIPTION

The iliopsoas compartment is a retroperitone...

DIAGNOSIS

Diagnosis is often difficult.

CT scan and MRI are the preferred imaging modalities; definitive diagnosis is made through image-guided percutaneous drainage (PCD) and culture.
Abscess aspirate...

TREATMENT

Most cases require PCD or open surgical drainage and parenteral antibiotics (16–20% success with antibiotics alone) (5)[B].
CT-guided PCD is initial procedure of choice due to its safe and n...

ONGOING CARE

Following drainage, pigtail catheter placement permits continued decompression of the abscess cavity and monitoring of purulent output. Catheters can be removed once drainage is consisten...

REFERENCES

Ouellette L, Hamati M, Flannigan M, et al. Epidemiology of and risk factors for iliopsoas abscess in a large community-based study. Am J Emerg Med. 2019;37(1):158–159. doi: 10.1016/j.ajem....

ADDITIONAL READING

Akhan O, Durmaz H, Balcı S, et al. Percutaneous drainage of retroperitoneal abscesses: variables for success, failure, and recurrence. Diagn Interv Radiol. 20...

CODES

ICD10

K68.12 Psoas muscle abscess

SNOMED

266463007 Iliopsoas abscess

CLINICAL PEARLS

Psoas abscesses are rare, retroperitoneal collections of pus resulting from hematogenous, lymphatic, or contiguous spread of infection.
Primary psoas abscesses are due to hematogenous o...

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