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[Psoas abscesses. Genesis, diagnosis, and therapy].
Chirurg. 2003 Jul; 74(7):677-82.C

Abstract

BACKGROUND

A psoas abscess is a rarely encountered entity with various etiologies and nonspecific clinical presentation, frequently resulting in delayed diagnosis, increased morbidity, and prolonged or recurrent hospitalization.

PATIENTS AND METHODS

Between January 1996 and January 2002 we treated ten patients (approximately 54.8, 5 males,5 females). These cases were analyzed retrospectively relative to a review of the literature.

RESULTS

CT scanning was decisive in the final diagnosis of psoas abscess. Primary psoas abscess occurred in four cases and six patients had secondary abscesses. In all except one case, the psoas abscess was located on the right side. The causes of primary abscesses were retroperitoneal perforated appendicitis, paravertebral injections for lumboischialgia, Pott's disease, and repeated intravenous drug application in the groin. Five patients underwent retroperitoneal open drainage and four patients CT-guided drainage. One patient with retroperitoneal perforated appendicitis was treated by laparotomy. Staphylococcus aureus, Bacteroides fragilis, and Escherichia coli were the most common infective agents. There was no postoperative mortality and no cases of abscess recurred.

CONCLUSIONS

CT scan is a diagnostic "gold standard" for psoas abscess. CT-guided drainage is the method of first choice, but is not possible in all cases. Open retroperitoneal drainage is a standard method of treatment. Postoperative antibiotic therapy is obligatory and should be adapted individually.

Authors+Show Affiliations

II.Chirurgischer Lehrstuhl der Universität zu Köln, Klinikum Cologne-Merheim. michael.korenkov@uni-koeln.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

ger

PubMed ID

12883797

Citation

Korenkov, M, et al. "[Psoas Abscesses. Genesis, Diagnosis, and Therapy]." Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen, vol. 74, no. 7, 2003, pp. 677-82.
Korenkov M, Yücel N, Schierholz JM, et al. [Psoas abscesses. Genesis, diagnosis, and therapy]. Chirurg. 2003;74(7):677-82.
Korenkov, M., Yücel, N., Schierholz, J. M., Goh, P., & Troidl, H. (2003). [Psoas abscesses. Genesis, diagnosis, and therapy]. Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen, 74(7), 677-82.
Korenkov M, et al. [Psoas Abscesses. Genesis, Diagnosis, and Therapy]. Chirurg. 2003;74(7):677-82. PubMed PMID: 12883797.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Psoas abscesses. Genesis, diagnosis, and therapy]. AU - Korenkov,M, AU - Yücel,N, AU - Schierholz,J M, AU - Goh,P, AU - Troidl,H, PY - 2003/7/29/pubmed PY - 2003/12/11/medline PY - 2003/7/29/entrez SP - 677 EP - 82 JF - Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen JO - Chirurg VL - 74 IS - 7 N2 - BACKGROUND: A psoas abscess is a rarely encountered entity with various etiologies and nonspecific clinical presentation, frequently resulting in delayed diagnosis, increased morbidity, and prolonged or recurrent hospitalization. PATIENTS AND METHODS: Between January 1996 and January 2002 we treated ten patients (approximately 54.8, 5 males,5 females). These cases were analyzed retrospectively relative to a review of the literature. RESULTS: CT scanning was decisive in the final diagnosis of psoas abscess. Primary psoas abscess occurred in four cases and six patients had secondary abscesses. In all except one case, the psoas abscess was located on the right side. The causes of primary abscesses were retroperitoneal perforated appendicitis, paravertebral injections for lumboischialgia, Pott's disease, and repeated intravenous drug application in the groin. Five patients underwent retroperitoneal open drainage and four patients CT-guided drainage. One patient with retroperitoneal perforated appendicitis was treated by laparotomy. Staphylococcus aureus, Bacteroides fragilis, and Escherichia coli were the most common infective agents. There was no postoperative mortality and no cases of abscess recurred. CONCLUSIONS: CT scan is a diagnostic "gold standard" for psoas abscess. CT-guided drainage is the method of first choice, but is not possible in all cases. Open retroperitoneal drainage is a standard method of treatment. Postoperative antibiotic therapy is obligatory and should be adapted individually. SN - 0009-4722 UR - https://www.unboundmedicine.com/medline/citation/12883797/[Psoas_abscesses__Genesis_diagnosis_and_therapy]_ DB - PRIME DP - Unbound Medicine ER -