Effectiveness of Percutaneous Catheter Drainage for Tuberculous Iliopsoas Abscess associated with Tuberculous Spondylitis

ABSTRACT

PURPOSE: To evaluate the efficacy of percutaneous catheter drainage of tuberculous abscess associated with tuberculous spondylitis. MATERIALS AND METHODS: In twelve patients (malefemale = 12; mean age, 37.3 years) tuberculous abscess was diagnosed, and was treated by percutaneous abscess drainage (PAD). All patients had either a psoas or iliopsoas abscess and in two, a paravertebral abscess was also present. Four had bilateral lesions, one, a unilateral lesion, and one, paravertebral abscesses and bilateral psoas. The size of abscesses ranged from4x5x12cm to 6x9x30cm; four were septated and all were lobulated. Using an 8.5-14F catheter, 17 of 18 abscesses were percutaneously drained; Ultrasound guidance was used in 12 cases, and CT guidance in five. RESULTS: The volume of drainage mater ranged from 150 to 1200 cc(mean, 600cc), and the duration of catheter insertion was 6-48 (mean, 17.4) days. In no patient did significant complications arise during or after drainage, and in all cases, follow-up studies using ultrasound, CT or MRI were performed. The duration of follow-up ranged from 3 to 35 (mean,15.4) months; during this time, no recurrence was noted. CONCLUSION: Chemotherapy alone is sufficient for treating a small tuberculous psoas or iliopsoas abscess, but for a large abscess, adjuvant drainage is necessary.