Laparoscopic Drainage of Iliopsoas Abscess

Syed Ali A. Rizvi, MB BS, Jeannine McManus, MB BS, Gary Foo, MB BS, Phil Lockie, FRCSI, FRACS

Department of General Surgery, Ipswich General Hospital, Queensland, Australia (all authors).

ABSTRACT

Introduction: Iliopsoas abscess is a rare condition that carries a risk of mortality when not treated appropriately. There is a paucity of high-level evidence concerning the management of this abscess and very sparse data is available in the literature regarding treatment options. This article discusses the treatments for iliopsoas abscess and reports a case effectively drained laparoscopically through an extraperitoneal approach.

Case Description: We present a case report of primary iliopsoas abscess.

Discussion: Computed tomography (CT) is the best imaging modality for visualizing iliopsoas abscess, and retroperitoneal laparoscopic drainage is an ideal approach for treatment of primary abscesses. Management options include antibiotics, percutaneous aspiration, percutaneous drainage, and laparoscopic or open surgical drainage. A laparoscopic extraperitoneal approach is an effective treatment option, as it allows more complete drainage compared with washout of the abscess cavity, reduced postoperative pain, and a shorter hospital stay.

Key Words: Iliopsoas abscess, Percutaneous abscess drainage, Retroperitoneoscopic drainage, Extra peritoneal, Primary abscesses.

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