ILIO-PSOAS ABSCESS IN THE PEDIATRIC POPULATION - TREATMENT BY US-GUIDED PERCUTANEOUS DRAINAGE

Background. Image-guided percutaneous drainage has been shown to be a safe and effective alternative to surgery in the management of psoas a bscess in adults and adolescents. There is little information on its u se in children. Objective. To evaluate the safety and efficacy of US-g uided percutaneous needle aspiration and catheter drainage of ilio-pso as abscesses. Materials and methods. A retrospective review of 14 chil dren with 16 ilio-psoas abscesses (10 pyogenic and 4 tuberculous) who were treated by US-guided percutaneous needle aspiration (n = 5) or ca theter drainage (n = 9) along with appropriate antimicrobial therapy. Results. Percutaneous treatment was successful in 10 of the 14 patient s; all showed clinical improvement within 24-48 h of drainage and subs equent imaging demonstrated resolution of the abscess cavities. Surger y was avoided in all of these ten patients except one, who underwent o pen surgical drainage of ipsilateral hip joint pus. Of the other four patients, two had to undergo surgical drainage of the ilio-psoas absce sses after failure of percutaneous treatment, one improved with antibi otics after needle aspiration failed to yield any pus, and one died of continuing staphylococcal septicaemia within 24 h of the procedure. T here were no procedural complications. Conclusions. Percutaneous drain age represents an effective alternative to surgical drainage as a supp lement to medical therapy in the management of children with ilio-psoa s abscesses.