[Treatment of primary pyogenic abscess of the psoas: retrospective study of 18 cases].

The primitive abcess of psoas muscle is a rare affection which involves mainly the young. The authors report 18 cases of primitive pyogenic abcess of psoas collected during a period of six years in the urology service of UHC Ibn Rochd Casablanca. The purpose of this review is to discuss the different therapeutic attitudes. The study concerned 11 men and seven women, their mean age was 35 years. The mean delay of evolution was 45 days. The physical exam found a psoitisis (five cases) and a flunk swelling (14 cases). The ultrasound exam showed the collection which was hypoechogenic in seven cases and heterogenous in 11 cases. The CT scan showed an heterogenouse hypodense collection without enhansment in seven cases. The use of antibiotherapy alone (four cases) and percutaneous drainage (four cases) permitted the recovery just respectively in one and two cases. Fifteen patients (83%) were operated through a postero-lateral lumbotomy route without costal resection. The bacteriological exam of the pus found a Staphylococcis aureus (ten cases) and Escherichia coli (two cases). The evolution was favorable in 14 cases; one patient was dead at fifth day post operatively by heart infarction. For the authors, the surgical drainage remains the treatment of choice.