[Psoas abscess: diagnostic and therapeutic usefulness of echography and computerized tomography].
BACKGROUND
Psoas abscess (PA) is a clinically infrequent entity. The abscess may form spontaneously (primary PA) or as a complication of contiguous infection (secondary PA). The use of ultrasonography (US) and computerized tomography (CT) facilitates diagnosis and treatment of a disorder which previously required surgery.


METHODS
Nineteen cases of PA diagnosed over the last 7 years were retrospectively studied. Confirmation of diagnosis was established by exteriorization of pus with US, CT or during surgery.


RESULTS
Three primary PA (16%) and 16 secondary PA (84%) were diagnosed. The foci of origin of the secondary PA were: urologic (50%), rachydeal (25%), gastrointestinal (12.5%) and iatrogenic lumbar infection (12.5%). The most frequent germs in the primary PA were: Staphylococcus aureus (67%) and in the secondary PA, enterobacteriae (50%). The diagnostic profitability of US was 41% (7/17) and for CT was 100% (15/15). Percutaneous drainage was performed in 9 patients which failed in 2 cases due to compactness of pus (22%) and in another 2 because of undiagnosed osteomyelitis (22%). Two patients (10%) with underlying disease died despite adequate medical-surgical treatment.


CONCLUSIONS
Psoas abscess were secondary in 84% of the patients studied with most being due to enterobacteriae. The diagnostic profitability of computerized tomography was greater than that of ultrasonography (100% vs 41%). Percutaneous drainage is a valid therapeutic alternative. Relapse observed in this study was due to previously undiagnosed osteomyelitis.
Córdoba
J
J
Sección de Enfermedades Infecciosas (Servicio de Medicina Internal), Universidad Autónoma de Barcelona.
Pigrau
C
C
Pahissa
A
A
Almirante
B
B
Gasser
I
I
Martínez-Vázquez
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016659:Psoas Abscess / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
Absceso de psoas: utilidad diagnóstica y terapéutica de la ecografía y de la tomografía computadorizada.