A COMPARATIVE STUDY BETWEEN PERCUTANEOUS DRAINAGE AND OPEN SURGICAL DRAINAGE AS A TREATMENT MODALITY FOR ILIOPSOAS ABSCESS

Abstract

Introduction: Most of the relevant literature on Iliopsoas Abscess(IPA) is in the form of case reports and short case series.[1] The incidence of IPA is reported to be 12 new cases per year worldwide.[2] A secondary IPA shows direct extension of infection from a neighbouring organ, and primary IPA shows hematogenous spread from an unknown source.[3,4]Computed Tomography(CT) and Magnetic Resonance Imaging(MRI) have helped in the early diagnosis of IPA.[8,9] Treatment consists of adequate drainage. Aim:To compare percutaneous drainage and open surgical drainage as a treatment modality for iliopsoas abscess. Settings and Design: Retrospective study. Methods and Materials: All patients aged 18 to 60years with IPA admitted to the Department of GeneralSurgery of our institute, between 1st of March, 2012 and 31st of July, 2022 were included. Results: Nineteen out of thirty patients(63.3%) were males. Average age was 30.5years. Seventeen(56.7%) cases had primary IPAs, and Staphylococcus spp. was the most common isolate. Thirteen(43.3%) cases had secondary IPAs, with spinal tuberculosis being the most common underlying condition. Eight patients(26.7%) were subjected to open surgical drainage and 22(73.3%) to percutaneous drainage(PCD) under ultrasound(US) guidance. Nine-and-a-half days on an average, were spent in the hospital. 8.5 days vs. 12.1 days, was the hospital stay for PCD patients compared to open drainage patients. The overall recurrence rate was 10%. No mortality was recorded. Conclusion: When utilized to treat IPAs, US guided PCD with proper antibiotics is secure and productive, with a shorter hospital stay. Open surgical drainage may be required if the IPA is multiloculated or if there is an underlying disease.