Ultrasound-guided anteroposterior percutaneous catheter drainage for the treatment of psoas abscess: A case series

Psoas abscess (PA) is a rare but potentially life-threatening condition that requires prompt intervention. The role of ultrasound-guided percutaneous catheter drainage (US-PCD) via the anterior-posterior (AP) approach warrants further evaluation. This case series retrospectively analyzed 10 patients with PA who underwent US-guided AP-PCD at Beijing Friendship Hospital. Data collected included procedure duration, pre- and postoperative clinical examinations, inflammatory markers, and imaging findings. Technical success was achieved in all cases (median procedure time: 18.5 minutes). Postprocedural Visual Analog Scale (VAS) pain scores decreased within 24 hours. By postoperative day 3, eight patients had normalized body temperature and white blood cell (WBC) counts. Median C-reactive protein (CRP) levels decreased from 151.3 mg/L (range: 58.0-269.4) preoperatively to 49.5 mg/L (range:38.7-186.1) postoperatively. During a follow-up period of 1-6 months, six patients achieved clinical success without further intervention, two required surgical debridement, and two died. This case series demonstrates that US-guided AP-PCD represents a feasible and safe minimally invasive option for selected patients with PA, offering the advantages of real-time guidance and no radiation exposure. However, given the modest success rate (60%) and etiological heterogeneity of this cohort, larger prospective studies are needed to validate its clinical role.