DRAINAGE PERCUTANÉ DANS LES ABCÈS SECONDAIRES DU PSOAS

Introduction: We report a series of 15 cases of secondary psoas abscess, showing its diagnostic and therapeutic difficulties aiming at evaluating the interst of precutaneous drainage role in its treatment. Materials and methods: It is a monosentric retrospective study lastes fer 5 years (Januarg 2003 - December 2007). The study based on the clinical and aperative reports, radiological and bacteriological findings. Results: The study includes 15 cases aged 14 to 72 years old, the average was 31.4 years with slight male predominance 9 males to 6 females. Diagnosis has been done by the ultrasound and scanner examinations. 6 cases have (Crohm’s disease, 3 retroc ecal apprendicitis, 2 tuberculous spondylitis 2 on top of colon tumors, 1 with diverticulitis and 1 post traumatic case. The most causative germes were gram-negative of digestive origin. In addition to the antibiotic treatment, 8 patients were operated from the start, 3 cases operated after a precutaneous drainage and 4 cases had a precutaneous drainage only which was effective. Conclusion: The secondary psoas abscesses are rare. As the clinical picture is less specific and hides the original pathology, which must be searched for and treated, diagnosis delayed. The most efficient treatment is the combined surgical and antibiotic one. The precutaneous drainage has its role in treating secondary psoas abscesses. At least it defers the surgical treatment to be done in better conditions latter on during the second step.