title: Retroperitoneoscopic drainage of bilateral psoas abscesses under intraoperative laparoscopic ultrasound guidance.
abstract: Despite improved diagnostic modalities for psoas abscesses, the optimum management strategy is not uniform. A 67-year-old man presented with bilateral psoas abscesses secondary to L1-L2 pyogenic discitis. On contrast-enhanced CT, the largest of these abscesses measured 13 × 14 × 33 mm on the right. The patient developed sepsis caused by Klebsiella pneumonia. There were no signs of improvement after 3 weeks of systematic antibiotic administration. We performed surgical drainage of bilateral psoas abscesses by retroperitoneoscopy. Intraoperative laparoscopic ultrasound was useful to determine abscess location in the muscles prior to drainage and confirm no residual abscesses after drainage. The patient was afebrile 3 days later, and his clinical symptoms resolved. Retroperitoneoscopic drainage may represent a feasible minimally invasive therapeutic option for psoas abscess, and intraoperative laparoscopic ultrasound has the potential to increase the safety and efficacy of this surgical procedure.
authors.affiliation: Department of Urology, Toyama City Hospital, Toyama, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Kodama
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Takase
authors.forename: Isamu
authors.initials: I
authors.lastname: Motoi
authors.forename: Hideki
authors.initials: H
authors.lastname: Mizuno
authors.forename: Kenichi
authors.initials: K
authors.lastname: Goshima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sawaguchi
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D004322:Drainage / Q000379:methods; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D016659:Psoas Abscess / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
keywords: Intraoperative laparoscopic ultrasound; laparoscopic surgical procedure; psoas abscess