Iliopsoas abscess: a report of 24 patients diagnosed by CT

Abstract

CT is an effective imaging technique for diagnosing iliopsoas abscess, even when classic clinical signs are absent. Treatment by percutaneous drainage under CT guidance is another advantage. When a psoas abscess is a complication of Crohn's disease, resection of the affected bowel segment is recommended in addition to drainage because drainage alone even in conjunction with appropriate medical therapy is usually not effective.

The iliopsoas abscess: aetiology, therapy, and outcome

“…Whilst CT scan is accepted as 'gold standard' in diagnostics [15], the question of whether abscess drainage should be performed by operation or CT-guided PD is still a matter of discussion even if PD getting to be more and more the method of choice [16,17]. We could not confirm the results of Cantasdemir [18] who found PD effective in 21 out of 22 cases.…”

“…To demonstrate the severity of illness, we used the APACHE II score, including temperature, blood pressure, heart rate, respiratory rate, arterial pH, oxygenation, serum sodium, serum potassium, serum creatinine, haematocrit, WBC count, Glasgow coma score, age and chronic health [5]. Patient scores on the day of intervention are summarised in Fig.…”

“…Even if the incidence of tuberculosis is actually increasing, in Western countries, tuberculosis abscesses are rare. Due to modern imaging techniques, it seems that this diagnosis with un-characteristic clinical symptoms has become more frequent [5]. However, despite the improvement of diagnosis, this disease remains dangerous as the development of abscesses is often related to some underlying chronic illness.…”

Psoas Abscess after Radical Abdominal Hysterectomy: A Case Report and Review of the Literature

“…The most common CT feature of an abscess is a focal hypodense lesion within a larger muscle. Other specific characteristics are the presence of air-fluid level or gas bubbles and irregular margins of the lesion [24]. CT can also identify a retroperitoneal or intra-abdominal disease process as the cause for the abscess.…”

A late diagnosis of Pott’s disease in an adolescent with psoas abscess

“…Among them CT is considered as gold standard [12]. Ultrasonography is an easily available first step screening technique, but it has lower sensitivity and specificity than CT [13]. We also utilized MRI due to its advantage in determining pathologies of the spine.…”