Treatment of the primary pyogenic abscess of the psoas muscle: retrospective study of 18 cases

The primitive abcess of psoas muscle is a rare affection which involves mai nly the young. The autors report 18 cases of primitive pyogenic abcess of p soas collected during a period of six years in the urology service of UHC I bn Rochd Casablanca. The purpose of this review is to discuss the different therapeutic attitudes. The study concerned 11 men and seven women, their m ean age was 35 years. The mean delay of evolution was 45 days. The physical exam found a psoitisis (five cases) and a flunk swelling (14 cases). The u ltrasound exam showed the collection which was hypoechogenic in seven cases and heterogenous in 11 cases. The CT scan showed an heterogenous hypodense collection without enhansement in seven cases. The use of antibiotherapy a lone (four cases) and percutaneous drainage (four cases) permited the recov ery just respectively in one and two cases. Fifteen patients (83%) were ope rated through a postero-lateral lumbotomy route without costal resection. T he bacteriological exam of the pus found a Staphylococcis aureus (ten cases ) and Escherichia coil (two cases). The evolution was favorable in 14 cases ; one patient was dead at fifth day post operatively by heart infarction. F or the autors, the surgical drainage remains the treatment of choice. (C) 2 001 Editions scientifiques et medicales Elsevier SAS.