Mehmet Guli ÇETİNÇAKMAK, Haluk SÖYLEMEZ, Namık Kemal HATİPOĞLU, Mazhar UTANGAÇ, Mehmet Nuri BODAKÇI, Mansu DAĞGÜLLİ, Nebahat HATİPOĞLU

Psoas apselerinde etyolojik faktörler

Amaç: Psoas apsesi (PA) nadir görülen, zor tanı konulabilen bir enfeksiyon hastalığıdır. Bu çalışmada PA tanısı olan hastaları etyolojik faktörler ve tedavi sonuçları açısından değerlendirmeyi amaçladık.Yöntemler: Aralık 2006-Ocak 2013 tarihleri arasında PA tanısı konulan 20 hastanın dosyaları geriye dönük olarak tarandı. Çalışmaya ultrasonografi ve/veya bilgisayarlı tomografi ile kesin PA tanısı konulan ve tüm verilerine ulaşılan hastalar dahil edildi.Bulgular: Çalışmaya alınan 20 hastanın yaş ortalaması: 48,8 yıl, 6'sı kadın, 14'ü erkek idi. Hastaların 12'sinde (%60) sağ tarafta, 7'sinde (%35) sol tarafta ve 1'inde (%5) bilateral olarak PA görülmekteydi. Olguların 4'ünde (%20) diyabet, 2'sinde (%10) hipertansiyon, 1'inde (%5) serebrovasküler hastalık, 1'inde (%5) tüberküloz, 1'inde (%5) hipertroidi, 1'inde (%5) mental retardasyon, 1'inde (%5) parapleji olduğu kaydedildi. Olguların 6 tanesi primer (%30) ve 14 tanesi sekonder (%70) psoas apsesi (pPA, sPA) olarak değerlendirildi. 13 hastaya (%65) perkütan drenaj, 3 hastaya (%15) eksplorasyon yapıldı. Psoas apsesi olan 4 hastaya (%20) sadece medikal tedavi verildi. Sonuç: Psoas apsesinin nadir görülmesi, değişken ve özgün olmayan kliniği tanı koymada güçlüğe neden olabilmektedir. Gelişmiş ve gelişmekte olan ülkelerde sPA'inde en sık neden Pott hastalığı ve Chron hastalığı olarak bildirilmekle beraber açık cerrahi ve üriner sistem taş hastalığının da etyolojik faktörler arasında önemli bir yer alabildiği dikkate alınmalıdır.

Etiological factors of psoas abscesses

Objective: Psoas abscess (PA) is a rare infection disease, which is difficult to diagnose. In the present study, we aimed to evaluate etiological factors and treatment results of patients with PA. Methods: Files of 20 patients who were diagnosed as PA between December 2006 and January 2013, were retrospectively analyzed. Patient's whose data were entirely reached and diagnosed by Ultrasonography and/or Computed Tomography as an exact PA were included to the study. Results: The mean age of the 20 patients was 48.8 year, and 6 of them were female and remaining were male. Psoas abscess were on the right side in 12 patients (60%), on the left side in seven patients (35%), and bilateral in one (5%). According to data records four patients had Diabetes Mellitus (20%), two had Hypertension (10%), one had cerebrovascular disease (5%), one had tuberculosis (5%), one had hyperthyroidism (5%), one had mental retardation (5%), and one had paraplegia (5%). Six case (30%) were diagnosed as a primary psoas abscess (pPA, sPA) and remaining (n=14, %70) were diagnosed as secondary. Percutaneous drainage was performed to 13 patients (65%) and exploration was performed to three patients (15%) as a treatment modality. Remaining four patients (20%) were followed by medical treatment. Conclusion: Psoas abscess is rare and have variable and non-specific clinical characteristic, which may lead to difficulty in diagnosis. In developed and developing countries, it has been reported that the most common causes of sPA are Pott's disease, and Crohn's disease, also it should be taken into account that open surgery and urinary tract stone disease can receive a significant portion of the etiological factors.

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