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[科特迪瓦的腰大肌脓肿:18例报告]

[Psoas abscess in Cote d'Ivoire: a report of eighteen cases].

作者信息

Koffi E, Lebeau R, Ayégnon G

机构信息

Service de Chirurgie générale et digestive, CHU de Cocody, Abidjan, Cóte d'Ivoire.

出版信息

West Afr J Med. 2007 Jul-Sep;26(3):234-7. doi: 10.4314/wajm.v26i3.28317.

Abstract

BACKGROUND

Psoas abscess is a rarely encountered entity with a non specific clinical presentation resulting in delayed diagnosis and treatment. No published data exist on this disease in our country.

OBJECTIVE

To describe the diagnostic and therapeutic features of psoas abscesses in Côte d'Ivoire. Methodes: A retrospective study of 18 psoas abscesses seen over seven years in two teaching hospitals.

RESULTS

There were 10 women and eight men with a mean age of 35.7 years (range:16-62 years). The abscess was primary in 15 cases, secondary in three, right sided in 15 and left sided in three cases. Fever, abdominal pain, difficulties in walk, abdominal mass and psoitis were the main clinical signs. Ultrasonography allowed the diagnosis of psoas abscess in 14 cases and in the remaining 4 cases the diagnosis was done peroperatively. The germs were identified in 12 patients and were: Escherichia coli in 3 cases, Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae, Klebsiella pneumoniae in two cases each and Mycobacterium tuberculosis in one case. Patients were given antibiotics together with surgical drainage of the abscess (n=16) or percutaneous needle aspiration (n=2). Postoperative complications included parietal suppurations (n=5) and intraperitoneal abscesses (n=2). No death occurred.

CONCLUSION

For psoas abscess in our practice, ultrasonography is a useful diagnostic tool and surgical drainage remains an effective therapeutic method.

摘要

背景

腰大肌脓肿是一种罕见的疾病,临床表现不具有特异性,导致诊断和治疗延迟。我国尚无关于该疾病的公开数据。

目的

描述科特迪瓦腰大肌脓肿的诊断和治疗特点。方法:对两家教学医院七年间收治的18例腰大肌脓肿患者进行回顾性研究。

结果

10例女性,8例男性,平均年龄35.7岁(范围:16 - 62岁)。15例脓肿为原发性,3例为继发性,15例位于右侧,3例位于左侧。发热、腹痛、行走困难、腹部肿块和腰大肌炎是主要临床症状。超声检查确诊14例腰大肌脓肿,其余4例通过手术确诊。12例患者细菌培养结果明确,其中3例为大肠杆菌,金黄色葡萄球菌、铜绿假单胞菌、肺炎链球菌各2例,肺炎克雷伯菌2例,结核分枝杆菌1例。患者接受抗生素治疗并同时行脓肿切开引流术(n = 16)或经皮穿刺抽吸术(n = 2)。术后并发症包括腹壁化脓(n = 5)和腹腔脓肿(n = 2)。无死亡病例。

结论

在我们的临床实践中,超声检查是诊断腰大肌脓肿的有用工具,手术引流仍是有效的治疗方法。

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