# Giant Bilateral Iliopsoas Abscesses, Secondary to Pott’s Disease: Challenging Diagnostic–Therapeutic Protocol Management (Modern and Innovative Open Approach Technique Through J.L. Petit Triangle)—A Case Report and Literature Review

## TL;DR

This case report discusses a rare and complex case of vertebral tuberculosis causing large abscesses in the iliopsoas muscles and highlights the challenges in diagnosing and treating such conditions.

## Contribution

The paper presents a rare case and proposes a modern surgical approach through the J.L. Petit triangle for managing giant bilateral iliopsoas abscesses.

## Key findings

- Giant bilateral iliopsoas abscesses can arise from vertebral tuberculosis and are difficult to diagnose due to atypical symptoms.
- A multidisciplinary approach is essential for effective diagnosis and treatment of iliopsoas abscesses.
- The J.L. Petit triangle approach offers a novel surgical technique for managing such complex cases.

## Abstract

Background and Clinical Significance: Iliopsoas abscess has recently become a condition quite frequently present in our practice, arising through hematogenous or lymphatic dissemination (primary), or secondary to trauma or infectious–inflammatory vertebral, renal, or gastrointestinal diseases. It is often diagnosed with difficulty, due to the insidious and rather atypical symptomatology. The simultaneous relevance to neurosurgery, orthopedics, urology, rheumatology, and of course surgery, makes the iliopsoas abscess a real challenge in diagnosis and treatment for any of us, as well as collaboration between specialties. Case Presentation: The aim of this paper is to illustrate all this through a rare clinical case of vertebral tuberculosis, with giant abscesses of bilateral iliopsoas and comparison with data from the literature, through a review. Conclusions: The problems were related to the clinical–paraclinical, etiological diagnosis, surgical strategy, technique and tactics, surgical approach, treatment and immediate, and both long-term postoperative management. The ultimate goal is to reduce morbidity and mortality secondary to this often-disabling condition.