Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas abscesses.
OBJECTIVE
To report our experience with computed tomography (CT)-guided percutaneous catheter drainage (PCD) of iliopsoas abscesses.


METHODS
Twenty-two iliopsoas abscesses in 21 patients (11 women, 10 men) aged between 18 and 66 years (mean 36 years) were treated with PCD. Abdominal CT demonstrated the iliopsoas abscesses, which were definitively determined by Gram staining and aspirate cultures. Twenty of the 22 iliopsoas abscesses were primary and two were secondary. All PCD procedures were performed under local anaesthesia using a single-step trocar technique (n=19) or Seldinger technique (n=3).


RESULTS
PCD was an effective treatment in 21 out of the 22 iliopsoas abscesses. Recurrence was seen in three abscesses as minimal residual collections. Two of them resolved spontaneously with anti-tuberculous regimen. One required percutaneous needle aspiration. The procedure failed in a diabetic patient with a secondary abscess, who died due to sepsis. The length of time that catheters remained in place ranged from 21 to 75 days (mean 59.7 days). Complications included catheter dislocation in four abscesses, which required removal of dislocated catheters and indwelling new ones.


CONCLUSIONS
CT-guided PCD is a safe and effective front-line treatment of iliopsoas abscesses. Surgery should be reserved for failure of PCD and presence of contraindications to PCD.
Cantasdemir
M
M
Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, Istanbul, Turkey. cantas1@yahoo.com
Kara
B
B
Cebi
D
D
Selcuk
N D
ND
Numan
F
F
D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D016659:Psoas Abscess / Q000601:surgery*; D015641:Radiography, Interventional / Q000379:methods*; D012008:Recurrence; D013203:Staphylococcal Infections / Q000601:surgery*; D013211:Staphylococcus aureus; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014376:Tuberculosis / Q000601:surgery*