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Retroperitoneoscopic drainage of bilateral psoas abscesses under intraoperative laparoscopic ultrasound guidance
Author(s) -
Kodama Koichi,
Takase Yasukazu,
Motoi Isamu,
Mizuno Hideki,
Goshima Kenichi,
Sawaguchi Takeshi
Publication year - 2014
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12091
Subject(s) - medicine , abscess , surgery , drainage , ultrasound , laparoscopy , radiology , discitis , magnetic resonance imaging , ecology , biology
Despite improved diagnostic modalities for psoas abscesses, the optimum management strategy is not uniform. A 67‐year‐old man presented with bilateral psoas abscesses secondary to L1 – L 2 pyogenic discitis. On contrast‐enhanced CT , the largest of these abscesses measured 13 × 14 × 33 mm on the right. The patient developed sepsis caused by K lebsiella pneumonia . There were no signs of improvement after 3 weeks of systematic antibiotic administration. We performed surgical drainage of bilateral psoas abscesses by retroperitoneoscopy. Intraoperative laparoscopic ultrasound was useful to determine abscess location in the muscles prior to drainage and confirm no residual abscesses after drainage. The patient was afebrile 3 days later, and his clinical symptoms resolved. Retroperitoneoscopic drainage may represent a feasible minimally invasive therapeutic option for psoas abscess, and intraoperative laparoscopic ultrasound has the potential to increase the safety and efficacy of this surgical procedure.