Treatment of Psoas Abscess with Underlying Crohn's Disease
Iliopsoas abscess arising as a complication of Crohn's disease requires a coordinated approach that accounts for both the abscess and the underlying bowel pathology. Crohn's disease is the commonest cause of secondary iliopsoas abscess, making this a clinically distinct presentation.
Clinical scenario
This protocol addresses iliopsoas (psoas) abscess with underlying Crohn's disease. Because the abscess is secondary to active intestinal disease, management ideally addresses both conditions together — performing a single operation to drain the abscess and resect the diseased bowel is considered the preferred surgical approach.
Treatment approach
Initial management combines broad-spectrum antibiotic therapy with image-guided drainage of the abscess. CT-guided percutaneous drainage can serve as a useful stabilising step to improve the patient's condition ahead of any surgical intervention.
The complete sequenced regimen — including antibiotic selection, drainage technique, and surgical coordination — is available in the full protocol.
References
DOI: 10.1136/pgmj.2003.017665
Crohn's disease is the commonest cause of secondary iliopsoas abscess.
In patients with Crohn's disease, performing a single operation to drain the abscess and resect the diseased bowel is desirable.
Treatment involves the use of appropriate antibiotics along with drainage of the abscess.
Sometimes PCD can be a useful initial treatment to improve the patient's condition before surgery.
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