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KMID : 0371319680100030147
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Journal of the Korean Surgical Society
1968 Volume.10 No. 3 p.147 ~ p.159
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Acute Non-tuberculous Psoas Abscess
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權宏保/Kwun, K.B.
鄭在龍/徐錤植/崔昌祿/Sibley, J.R./李鐵/Jung, J.R./Suh, K.S./Choi, C.R./--/Lee, C.
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Abstract
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Fifty three cases of acute non-tuberculous psoas abscess have been observed from July 1958 to September 1967. The authors have reviewed and discussed a number of factors including the age, sex distribution, site involved, seasonal fluctuation, clinical symptoms and findings, previous history, diagnosis and treatment.
The authors have also reported 4 interesting cases.
Significant conclusions drawn from this study were as follows:
1) The abscess may be seen in any age group, but it affects more often young people under 10 years of age.
2) There was a predominance of male patients, and the Rt. psoas was more often involved.
3) There were two fluctuations in the seasonal incidence curve. The abscess more prevalent in the summer and late winter.
4) Important clinical syptoms and findings were:
(1) High fever and chilliness.
(2) Pain in the area of the affected iliac fossa, hip and lower abdomen.
(3) Flexion Contracture of the involved hip joint, and an associated limp.
(4) Tenderness or a tender mass in the lower abdomen, iliac fossa or flank of the involved side.
5) X-ray of lumbar spine and preoperative aspiriation of the abscess were helpful in substantiating the diagnosis and in excluding spinal tuberculosis.
6) In the majority of cases, the causative organisms were hemolytic staphylococcous aureus, mannitol and coagulase positive.
7) Extraperitoneal drainage of pus through a McBurney´s incision seemed to be significantly better than other procedures advocated.
8) Post-op. application of Buck´s extension apparatus may help early extension of the affected hip.
In the past, ti was postulated that the psoas abscess could arise from infection and suppuration of lumbar retroperitoneal glands or infection of an old hemorrhage inside the psoas seath.
However, in view of associated infection, the authors herein have discussed why they believe a psoas abscess may well arise by secondary hematogenous infection of psoas muscle itself from another focus of infection elsewhere in the body.
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