Pyogenic psoas abscess: discussion of its epidemiology, etiology, bacteriology, diagnosis, treatment and prognosis - case report

Psoas muscle abscess is a rare condition with vague clinical presentation, which presents a diagnostic challenge requiring a high index of suspicion. We report a case of primary pyogenic psoas abscess caused by Staphylococcus aureus. In this article, the epidemiology, etiology, bacteriological diagnosis and treatment options of this condition are discussed

Evaluation of ultrasonography in the diagnosis of suspected acute appendicitis

To assess the efficacy of ultrasound [US] as a diagnostic modality to establish the indications for surgery in patients suspected for acute appendicitis with equivocal clinical pictures. Design: Prospective randomized study. Setting: Departments of Surgery and Radiology, Al-Jahra Hospital, Al-Jahra, Kuwait. Subjects: A total of 148 patients suspected to have acute appendicitis admitted with equivocal clinical findings in the period from October 1997 to November 1999. Abdominal US using the graded compression technique. A positive US was defined as a tender non-compressible appendix with an outer wall to outer wall diameter of >6mm. The sonographic data w e re correlated with clinical, operative and pathological findings. Graded compression US results were analyzed and showed 97.4% specificity, 88.2% sensitivity, 95.3% accuracy, 90.9% positive predictive value, and 96.5% negative predictive value. The results are discussed and compared to previous reports. US was found to be a useful tool in the diagnosis of suspected cases of acute appendicitis with equivocal clinical findings. US helped to minimize negative laparotomies and avoid unnecessary appendectomies. US is, however, an operator-dependent investigative tool