Case Series of Iliopsoas Abscesses Treated at a University Hospital in Japan: Epidemiology, Clinical Manifestations, Diagnosis and Treatment.
OBJECTIVE
The incidence of iliopsoas abscesses has been increasing due to advances in diagnostic imaging techniques and the increased number of elderly individuals and immunodeficient patients with co-morbidities. Our aim was to investigate the management and treatment of iliopsoas abscesses, particularly the effectiveness of computed tomography (CT)-guided drainage in the era of interventional radiology.


METHODS
A retrospective analysis was performed at a university hospital between January 2009 and March 2014. Patients There were 15 patients (eight men, seven women) 50-85 years of age (average: 70 years) diagnosed with an iliopsoas abscess.


RESULTS
The etiology of the disease was investigated in 14 of the 15 patients, each of whom had a secondary iliopsoas abscess. The primary condition in nine of these patients (64.3%) was an orthopedic infection (spondylodiscitis); the most common symptom was fever (12 patients, 80%). Altogether, 10 patients (66.7%) had a multilocular abscess and five (33.3%) had bilateral abscesses. The most common pathogen was Staphylococcus aureus (seven patients, 50%). All 14 patients underwent drainage: 11 received CT-guided drainage, two underwent postdrainage surgery and one received ultrasonography-guided drainage. Poor drainage was overcome by inserting multiple drainage tubes (six patients) or performing transmembrane drainage with a guidewire. All but one patient survived.


CONCLUSIONS
Based on the high success rate of CT-guided drainage in this study, this technique is expected to continue to play a major role in cases requiring drainage, even in patients with bilateral or multilocular abscesses. However, this modality cannot be used in cases of gastrointestinal perforation.
Emergency and Critical Care Center, Mie University Hospital, Japan.
Kei
K
Suzuki
Takanori
T
Yamaguchi
Yoshiaki
Y
Iwashita
Kazuto
K
Yokoyama
Masaki
M
Fujioka
Naoyuki
N
Katayama
Hiroshi
H
Imai
D000368:Aged; D000369:Aged, 80 and over; D015299:Discitis / Q000150:complications* / Q000276:immunology; D004322:Drainage / Q000379:methods*; D005260:Female; D005334:Fever / Q000150:complications* / Q000276:immunology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016659:Psoas Abscess / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult