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Abscess, Psoas

Adriane E. Bell, MD Reviewed 06/2021
 


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.

  • Definitive organ...

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 (5)[B].

  • Open drainage...

ONGOING CARE

Following drainage, pigtail catheter placement permits continued decompression of the abscess cavity and monitoring of purulent output. 

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Follow-u...

REFERENCES

1
Navarro López V, Ramos JM, Meseguer V, et al. Microbiology and outcome of iliopsoas abscess in 124 patients. Medicine (Baltimore). 2009;88(2):120-130. [View Abstract on OvidMedline]
2
Shield...

ADDITIONAL READING

  • Akhan O, Durmaz H, Balcı S, et al . Percutaneous drainage of retroperitoneal abscesses: variables for success, failure, and recurrence. Diagn Interv Radiol. 2...

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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