Psoas Abscess Drainage

A psoas abscess is an abscess in one of the psoas muscles which extend from the lower spine into the groin. Primary psoas abscess occurs when bacteria such as Staph bacteria get into the muscle, creating an area of inflammation and infection which often fills with fluid, including pus. This is most commonly seen in children, although it can appear in people of any age.

A patient with a psoas abscess can experience:

  • lower back pain
  • pain in the abdomen
  • frequent urination
  • fever

The specifics of the procedure vary depending on the site of aspiration. In general, the skin over the site of aspiration is sterilized usually with a liquid iodine solution. A local anesthetic is then injected into the skin. The suctioning device (aspirator) is inserted into the fluid or tissue being collected. Using suction, the aspirator removes the desired amount of fluid or tissue that is collected in a sterile receptacle. The aspirator is removed and a bandage or other sterile dressing placed over the entry site.

Aspiration and drainage of the abscess may be done by directly placing a needle through the skin into the abscess (percutaneous), if the individual is not a surgical candidate. The percutaneous approach usually requires CT scanning to guide exact placement of the needle. If there is gastrointestinal involvement, surgery to correct the bowel condition (removal of a bowel segment) may be warranted.

Psoas abscess’ can recollect therefore can required extensive antibiotic treatment. Additionally this condition can require repeated drainage for patient comfort as well as re-culture. The aetiology of the source of the abscess is crucial for ongoing care.

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