Natsuko Hayashi1,2, Yoshito Takeuchi3, Hiroyuki Morishita4, Naoki Ehara5, Kei Yamada2. 1. Department of Radiology, North Medical Center, Kyoto Prefectural University of Medicine, 481 Otokoyama, Yosanocho, Yosagun, Kyoto, 629-2261, Japan. 2. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto, 6028566, Japan. 3. Department of Radiology, Fukuchiyama City Hospital, 231 Atsunakacho, Fukuchiyama, Kyoto, 6208505, Japan. yotake62@qg8.so-net.ne.jp. 4. Department of Diagnostic Radiology, Japan Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, 6050981, Japan. 5. Department of Emergency, Japan Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, 6050981, Japan.
Abstract
PURPOSE: To evaluate the feasibility and safety of the computed tomography (CT)-guided femoral approach for draining a psoas muscle abscess (PMA). MATERIALS AND METHODS: Between January 2014 and November 2018, the CT-guided femoral approach was employed for 9 abscesses in 8 patients who could not tolerate the prone position because of advanced age or other underlying conditions. A 17-gauge blunt metal needle was used to puncture the iliacus muscle below the groin under CT fluoroscopic guidance. A drainage catheter was then placed within the abscess cavity in the psoas major muscle. Technical success, clinical success, complications, the drainage therapy duration, susceptibility to antibiotics, survival, and recurrence were evaluated. RESULTS: The technical success rate was 100% among all nine lesions. The clinical success rate was 89% among all eight patients. One patient died of concomitant meningitis 15 days after the procedure. No patients developed therapy-related complications. The median duration of the drainage therapy was 15 days (range 6-71 days). Appropriate antibiotics based on the culture susceptibility were achieved in all patients. Four patients survived, and the remaining four died at 15 to 758 days (median, 36 days) after the procedure; no therapy-related deaths occurred. No recurrence was seen. CONCLUSION: The CT-guided femoral approach seems feasible, effective, and safe for draining psoas muscle abscesses in ill patients who cannot tolerate the prone position.
PURPOSE: To evaluate the feasibility and safety of the computed tomography (CT)-guided femoral approach for draining a psoas muscle abscess (PMA). MATERIALS AND METHODS: Between January 2014 and November 2018, the CT-guided femoral approach was employed for 9 abscesses in 8 patients who could not tolerate the prone position because of advanced age or other underlying conditions. A 17-gauge blunt metal needle was used to puncture the iliacus muscle below the groin under CT fluoroscopic guidance. A drainage catheter was then placed within the abscess cavity in the psoas major muscle. Technical success, clinical success, complications, the drainage therapy duration, susceptibility to antibiotics, survival, and recurrence were evaluated. RESULTS: The technical success rate was 100% among all nine lesions. The clinical success rate was 89% among all eight patients. One patient died of concomitant meningitis 15 days after the procedure. No patients developed therapy-related complications. The median duration of the drainage therapy was 15 days (range 6-71 days). Appropriate antibiotics based on the culture susceptibility were achieved in all patients. Four patients survived, and the remaining four died at 15 to 758 days (median, 36 days) after the procedure; no therapy-related deaths occurred. No recurrence was seen. CONCLUSION: The CT-guided femoral approach seems feasible, effective, and safe for draining psoas muscle abscesses in ill patients who cannot tolerate the prone position.
Authors: Sanjay Gupta; Huan Luong Nguyen; Frank A Morello; Kamran Ahrar; Michael J Wallace; David C Madoff; Ravi Murthy; Marshall E Hicks Journal: Radiographics Date: 2004 Jan-Feb Impact factor: 5.333
Authors: Michael M Maher; Debra A Gervais; Mannudeep K Kalra; Brian Lucey; Dushyant V Sahani; Ronald Arellano; Peter F Hahn; Peter R Mueller Journal: Radiographics Date: 2004 May-Jun Impact factor: 5.333