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Case report
Retroperitoneoscopic drainage of cryptogenic psoas abscess
  1. Caterina Froiio1,2,
  2. Daniele Tiziano Bernardi2,
  3. Emanuele Asti3 and
  4. Luigi Bonavina4
  1. 1Surgery, Universita degli Studi di Milano, Milano, Italy
  2. 2IRCCS Policlinico San Donato, San Donato Milanese, Lombardia, Italy
  3. 3Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Lombardia, Italy
  4. 4Department of General Surgery, IRCCS Policlinico San Donato, University of Milan, Milano, Italy
  1. Correspondence to Professor Luigi Bonavina; luigi.bonavina{at}


Psoas abscess is a rare and occasionally life-threatening condition. In the past, the major cause of psoas abscess was a descending infection originating from spine tuberculosis (Pott’s disease). Subsequently, secondary infection from spondylodiscitis or Crohn’s disease has become the prevalent aetiology. Conventional treatment ranges from antibiotic therapy alone to CT-guided and/or surgical drainage. We present the case of a 67-year-old man with a complex history, including pneumonia, sepsis and previous muscle-skeletal trauma. The patient subsequently developed a psoas abscess that was successfully treated with a minimally invasive retroperitoneoscopic approach and antibiotics. Blood cultures and pus yielded Gram-positive Streptococcus sp, and transesophageal echocardiography identified endocarditis as a possible source of sepsis. Postoperative clinical course was complicated by recurrent sepsis that required a change of antibiotic therapy. The patient was eventually discharged to rehabilitation care without further complications. The retroperitoneoscopic approach is safe and effective for the treatment of cryptogenic psoas abscess.

  • infections
  • adult intensive care
  • radiology
  • general surgery

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  • Contributors CF and LB contributed equally in writing the manuscript and reviewing the literature. DTB and EA reviewed the manuscript. All the authors were involved in patient care in this case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.