ILIO-PSOAS ABSCESSES - PERCUTANEOUS DRAINAGE UNDER IMAGE GUIDANCE

Over a 5-year period, 56 psoas abscesses occurring in 51 patients were managed by image-guided percutaneous drainage, either by needle aspir ation (n = 10) or by catheter drainage (n = 46) in conjunction with me dical therapy, Twenty-seven patients had tuberculous abscesses (bilate ral in five) while 24 patients had pyogenic abscesses, Percutaneous tr eatment was successful in 16 of the 24 patients (66.7%) with pyogenic abscesses, The reasons for failure were co-existent bowel lesions, phl egmonous involvement of muscle without liquefaction, multiloculated ab scess cavity and thick tenacious pus not amenable to percutaneous drai nage. Surgery was required in seven patients, either for failed percut aneous drainage or for the management of co-existent disease, Percutan eous drainage was initially successful in all 27 patients of tuberculo us psoas abscesses, However, eight patients presented with recurrence requiring repeat intervention, The average duration of catheter draina ge was longer in patients with tuberculous abscess (11 days) than in p atients with pyogenic abscess (6 days), Percutaneous drainage under im age guidance provides an effective and safe alternative to more invasi ve surgical drainage in most patients with psoas abscesses.