Iliopsoas Abscess: Presentation, Etiology, Treatment Options, and Outcomes: A Retrospective Analysis of 19 Cases

Authors

  • Khaled Faiz Department of Surgery, Ben-ghazi Medical Center Author
  • Jamal Gomati Department of Surgery, Ben-ghazi Medical Center Author
  • Tariq Elhoony 7th October Hospital Ben-ghazi-Libya Author
  • Tariq Aldarat Department of Surgery, Ben-ghazi Medical Center Author
  • Salah Eltaktouk Department of Surgery, Ben-ghazi Medical Center Author
  • Muftah Elkhafifi Al-hawari Center-Urology Department Benghazi-Libya Author
  • Ali Abokiash Al-hawari Center-Urology Department Benghazi-Libya Author
  • Raouf Kwafi Department of Surgery, Ben-ghazi Medical Center Author
  • Issa Abuzied Department of Surgery, Ben-ghazi Medical Center Author

DOI:

https://doi.org/10.54172/

Keywords:

Iliopsoas Abscess, Percutaneous Drainage, Open Drainage

Abstract

Iliopsoas abscess (IPA) is an exceptional condition with high rates of mortality and morbidity. Pyogenic abscesses (PAs), which account for more than half of iliopsoas abscesses, have developed comparatively more frequently as the prevalence of tuberculosis disease has diminished. Our study aims to analyze the presentation, treatment, and outcomes in 19 patients with a diagnosis of IPA. A retrospective analysis of 19 consecutive IPA cases managed at teaching hospitals (Benghazi Medical Center and Urology Center) Benghazi-Libya. Among 19 patients with a diagnosis of IPA, 12 were males (63.1 %) with a mean age of 50 years (range, 11 to 78 y). and 7 were females (36.9 %) with an average age of 41 (16 - 67) years the most frequent feature was lower abdominal pain (73.6 %), fever (57.8 %), followed by limping (36.8 %), and Weight loss (21.1 %). Leukocytosis was the most common laboratory finding (86.4 %), whereas anemia was the second most common laboratory finding found in (26.3%). Three patients (15.8 %) underwent ultrasound (U/S) with negative results before CT (computed tomography) which was the confirmatory scan for all patients. Six patients underwent open surgical drainage (31.6 %) and thirteen (68.4 %) were submitted to percutaneous drainage (PCD) under ultrasound guidance with an overall success rate of 97 %. Compared to surgery, PCD had a lower mean in-hospital stay. US-guided PCD along with the proper antibiotic medication is safe, effective, and results in a shorter hospital stay.

References

Afaq, A., Jain, B. K., Dargan, P., Bhattacharya, S. K., Rauniyar, R. K., & Kukreti, R. J. T. d. (2002). Surgical drainage of primary iliopsoas abscess—safe and cost-effective treatment. 32(3), 133-135.

Baier, P., Arampatzis, G., Imdahl, A., & Hopt, U. J. L. s. A. o. S. (2006). The iliopsoas abscess: aetiology, therapy, and outcome. 391(4), 411-417.

Benkhadoura, M. O., El-Mogassabi, A. H., Mansor, S. M., Abuzaid, I. A., Manita, M. A., Etabbal, A. M.,…Elshaikhy, A. I. J. I. S. J. (2019). Iliopsoas abscess: clinical presentation, management, and outcome. International Surgery Journal, 6(1), 17-21. https://doi.org/https://doi.org/10.18203/2349-2902.isj20185458

Cantasdemir, M., Kara, B., Cebi, D., Selcuk, N., & Numan, F. J. C. r. (2003). Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas abscesses. 58(10), 811-815.

Christin, L., & Sarosi, G. A. J. C. I. D. (1992). Pyomyositis in North America: case reports and review. 15(4), 668-677.

Kim, Y. J., Yoon, J. H., Kim, S. I., Wie, S. H., & Kim, Y. R. J. I. J. o. S. (2013). Etiology and outcome of iliopsoas muscle abscess in Korea; changes over a decade. 11(10), 1056-1059.

Kinoshita, M., Takao, S., Takechi, K., Takeda, Y., Miyamoto, K., Yamanaka, M.,…Tani, H. J. T. J. o. M. I. (2016). Percutaneous drainage of psoas and iliopsoas muscle abscesses with a one-step technique under real-time computed tomography fluoroscopic guidance. 63(3.4), 323-327.

Li, Y., Funakoshi, H., Shiga, T., & Fujitani, S. J. C. C. J. M. (2017). Iliopsoas abscess. 84(11), 833-834.

Livne, M., Serour, F., Aladjem, M., & Vinograd, I. J. E. j. o. p. s. (1994). General peritonitis induced by rectal examination: an unusual complication of primary psoas abscess. 4(03), 186-187.

López, V. N., Ramos, J. M., Meseguer, V., Arellano, J. L. P., Serrano, R., Ordóñez, M. A. G.,…Conde, A. J. M. (2009). Microbiology and outcome of iliopsoas abscess in 124 patients. 88(2), 120-130.

Mallick, I., Thoufeeq, M., & Rajendran, T. J. P. m. j. (2004). Iliopsoas abscesses. 80(946), 459-462.

Mynter, H. J. B. M., & Journal, S. (1881). Acute psoitis. 21(5), 202.

Negus, S., & Sidhu, P. J. T. B. j. o. r. (2000). MRI of retroperitoneal collections: a comparison with CT. 73(872), 907-912.

Ricci, M. A., Rose, F. B., & Meyer, K. K. J. W. j. o. s. (1986). Pyogenic psoas abscess: worldwide variations in etiology. 10(5), 834-842.

Tabrizian, P., Nguyen, S. Q., Greenstein, A., Rajhbeharrysingh, U., & Divino, C. M. J. A. o. s. (2009). Management and treatment of iliopsoas abscess. 144(10), 946-949.

Taiwo, B. J. S. m. j. (2001). Psoas abscess: a primer for the internist. 94(1), 2-5.

Wong, O., Ho, P., & Lam, S. J. H. K. m. j. X. y. x. z. z. (2013). Retrospective review of clinical presentations, microbiology, and outcomes of patients with psoas abscess. 19(5), 416-423.

Yacoub, W. N., Sohn, H. J., Chan, S., Petrosyan, M., Vermaire, H. M., Kelso, R. L.,…Mason, R. J. J. T. A. J. o. S. (2008). Psoas abscess rarely requires surgical intervention. 196(2), 223-227.

Yamagami, T., Terayama, K., Yoshimatsu, R., Matsumoto, T., Miura, H., & Nishimura, T. J. S. r. (2009). Percutaneous drainage of psoas abscess under real-time computed tomography fluoroscopic guidance. 38(3), 275-280.

Yeh, P., Jaw, W., Wang, T., Yen, T. J. Z. y. x. z. z. C. M. J., & ed, F. C. (1995). Evaluation of iliopsoas compartment disorders by computed tomography. 55(2), 172-179.

Downloads

Published

2025-08-03

Issue

Section

Articles

How to Cite

Faiz, K., Gomati, J., Elhoony, T., Aldarat, T., Eltaktouk, S., Elkhafifi, M., Abokiash, A., Kwafi, R., & Abuzied, I. (2025). Iliopsoas Abscess: Presentation, Etiology, Treatment Options, and Outcomes: A Retrospective Analysis of 19 Cases. Al-Mukhtar Journal of Sciences, 40(1), 30-37. https://doi.org/10.54172/