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    Iliopsoas abscess: a re-emerging clinical entity not to be forgotten.

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    Authors
    Al-Hilli, Z
    Prichard, R S
    Roche-Nagle, G
    Deasy, J
    McNamara, D A
    Issue Date
    2009-02
    MeSH
    Adult
    Aged
    Female
    Humans
    Immunocompromised Host
    Male
    Psoas Abscess
    
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    Citation
    Iliopsoas abscess: a re-emerging clinical entity not to be forgotten. 2009, 102 (2):58-60 Ir Med J
    Journal
    Irish medical journal
    URI
    http://hdl.handle.net/10147/127700
    PubMed ID
    19405324
    Abstract
    Iliopsoas abscesses are relatively rare clinical entities. They present with subtle and non-specific symptoms and as a result the diagnosis is often delayed, leading to significant morbidity and mortality. With an increasing number of immunocompromised patients in the population the prevalence of this condition is set to rise. Therefore, early diagnosis and appropriate management remain a challenge for clinicians. We present three patients with iliopsoas abscesses, two of which were primary and one of which was secondary to Crohn's disease. The average age of patients was 59 years and both patients with primary psoas abscesses were male. All presented with non-specific symptoms. Psoas sign was present in only one patient. CT confirmed the diagnosis in all cases. Treatment consisted of appropriate antibiotic cover and associated percutaneous drainage. The psoas abscess that was secondary to underlying Crohn's disease was subsequently treated with surgical excision of the affected segment of bowel and lavage of the abscess cavity. A high index of suspicion is required to ensure the accurate and early diagnosis of this rare clinical entity. Abdominal CT scanning remains the gold standard for diagnosis. Management is with appropriate antibiotics and adequate drainage. This can be achieved by either percutaneous or surgical drainage. Such treatment can reduce the overall morbidity and mortality of this condition.
    Item Type
    Article
    Language
    en
    ISSN
    0332-3102
    Collections
    Beaumont Hospital

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