Clinical analysis of diagnosis and treatment of six patients with iliopsoas abscess

FAN Feifei; E Bei; WANG Qianmei; CHEN Ke; CHEN Jijun

doi:10.3969/j.issn.1002-3429.2025.17.002

Abstract：Objective To analyze the diagnosis and treatment process as well as the prognosis of 6 patients with iliopsoas abscess(IPA),and to explore the characteristics of pathogens causing IPA due to different etiologies,the timing of puncture drainage and/or incision,and its relationship with prognosis.Methods Clinical data of 6 patients with IPA admitted from January 2020 to December 2023 were reviewed,and the general conditions,past medical history,clinical manifestations,treatment processes,and clinical outcomes of the patients were summarized,thereby concluding,treatment experiences from patients with different types of IPA.Results Among the 6 patients,5 were males and 1 was female,aged 21 to 67 years,including 4 patients with high-risk factors for the formation of IPA,and 3 patients presenting typical symptoms of IPA,mainly characterized by fever,low back pain,and difficulty walking.Upon admission to our hospital,1 patient underwent only puncture drainage,2 patients received incision and drainage due to a prolonged disease course at the time of consultation,and 3 patients required re-operation for inadequate infection control after initial drainage.Following treatment,4 patients improved,1 patient was transferred back to a local hospital and underwent 3 months of anti-inflammatory treatment before showing improvement,and 1 patient had a wide infection that required multiple debridements and subsequently suffered from a brain hemorrhage and multiple organ failure,ultimately leading to unsuccessful resuscitation.Conclusion Early identification and diagnosis,combined with timely debridement and drainage,are critical in reducing mortality associated with IPA.Patients with underlying gastrointestinal,renal,or uterine diseases,or those with a history of relevant surgeries or invasive procedures,should be vigilant about the potential spread of the primary lesion to the psoas region upon manifestation of this disease.Collaboration with relevant specialties is essential for managing the primary lesion during abscess treatment.