Changing etiology of iliopsoas abscess.

Abstract:

:Over a 5-year period, iliopsoas abscesses were found in 11 patients. Although the most common underlying condition was Crohn's disease (3 of 11 patients), 5 abscesses resulted from hematogenous spread from a distant site. Each of these five patients was elderly, severely malnourished, or had an underlying chronic disease. Fever was a presenting sign in 8 of 11 patients, whereas all 4 patients who presented with back pain had nontuberculous lumbar osteomyelitis or disk space infections. No patient presented with the classic triad of fever, back pain, and anterior thigh or groin pain. Computed tomographic (CT) scans accurately established the clinical diagnosis in 10 of 11 patients. Two of the patients died. One patient was an intravenous drug abuser, whereas the other patient was being treated with steroids for systemic lupus erythematosus. Elderly patients, diabetics, and patients with chronic disease are susceptible to this kind of occult infection and may present with minimal clinical findings. Aggressive diagnosis using CT scanning and treatment with resection of involved bowel, complete drainage of the abscess, and prolonged antibiotics are required to salvage these patients.

journal_name

Am J Surg

authors

Walsh TR,Reilly JR,Hanley E,Webster M,Peitzman A,Steed DL

doi

10.1016/0002-9610(92)90043-q

subject

Has Abstract

pub_date

1992-04-01 00:00:00

pages

413-6

issue

4

eissn

0002-9610

issn

1879-1883

pii

0002-9610(92)90043-Q

journal_volume

163

pub_type

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