Abdominal Computed Tomography for Postoperative Abscess: Is It Useful During the First Week?

Antevil, Jared L.; Egan, John C.; Woodbury, Robert O.; Rivera, Louis; O’Reilly, Eamon B.; Brown, Carlos

doi:10.1016/j.gassur.2005.12.006

Cited by 16 publications

(6 citation statements)

References 11 publications

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“…CT Abdomen and Pelvis. With a generally broad differential and need for fast imaging because of clinical acuity, CT is a preferred imaging option [23]. CT can be performed without and/or with intravenous (IV) contrast and with or without positive oral contrast.…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

“…CT of the abdomen and pelvis with IV contrast is often the first study and generally considered to be an optimal imaging modality for the evaluation of pain and suspected abscess in the postoperative patient. One study assessing the use of positive oral and IV contrast-enhanced CT scans obtained in all patients with suspected abscesses between 3 and 30 days demonstrated a similar diagnostic yield regardless of whether the scan was performed in the first postoperative week or later [23]. However, it is important to recognize that clinical suspicion can impact diagnostic yield.…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

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ACR Appropriateness Criteria® Acute Nonlocalized Abdominal Pain

Scheirey

Fowler

Therrien

et al. 2018

Journal of the American College of Radiology

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The range of pathology in adults that can produce abdominal pain is broad and necessitates an imaging approach to evaluate many different organ systems. Although localizing pain prompts directed imaging/management, clinical presentations may vary and result in nonlocalized symptoms. This review focuses on imaging the adult population with nonlocalized abdominal pain, including patients with fever, recent abdominal surgery, or neutropenia. Imaging of the entire abdomen and pelvis to evaluate for infectious or inflammatory processes of the abdominal viscera and solid organs, abdominal and pelvic neoplasms, and screen for ischemic or vascular etiologies is essential for prompt diagnosis and treatment. Often the first-line modality, CT quickly evaluates the abdomen/pelvis, providing for accurate diagnoses and management of patients with abdominal pain. Ultrasound and tailored MRI protocols may be useful as first-line imaging studies, especially in pregnant patients. In the postoperative abdomen, fluoroscopy may help detect anastomotic leaks/abscesses. While often performed, abdominal radiographs may not alter management.

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Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

ACR Appropriateness Criteria® Acute Nonlocalized Abdominal Pain

Scheirey

Fowler

Therrien

et al. 2018

Journal of the American College of Radiology

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“…It has generally been accepted that the utility of contrast-enhanced CT scans increases the longer it is after initial source control. One report suggested, however, that a good diagnostic yield is obtained even at 3-7 days after the index procedure with current generation CT scanners [651]. Nonetheless, because of the risk of false negative imaging in patients with IAI who have early treatment failure, excessive reliance should not be placed solely on CT scanning to determine the need for re-intervention.…”

Section: Agentmentioning

confidence: 99%

The Surgical Infection Society Revised Guidelines on the Management of Intra-Abdominal Infection

Mazuski

Tessier

May

et al. 2017

Surgical Infections

455

426

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“…The best imaging procedure for the diagnosis of abdominal abscesses is CT [13]. Ultrasonically guided fluid collection and abscess drainage are routine procedures in the diagnosis and treatment of abdominal abscesses.…”

Section: Intra-abdominal Abscessmentioning

confidence: 99%

Microbiology and Management of Abdominal Infections

Brook

2008

Dig Dis Sci

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This review describes the microbiology, diagnosis, and management of intra-abdominal infections. These infections include secondary peritonitis, abdominal abscesses, and cholangitis. The infection generally occurs because enteric microorganisms enter the peritoneal cavity through a defect in the wall of the intestine or other viscus as a result of obstruction, infarction, or direct trauma. Mixed aerobic and anaerobic flora can be recovered. The predominant aerobic isolates are Escherichia coli, etc. The aerobic isolates are Escherichia coli, and enterococci, and the main anaerobic bacteria are Bacteroides fragilis group Peptostreptococcus spp. and Clostridium spp. The treatment of abdominal infection includes surgical correction and drainage of pus and administration of antimicrobials effective against both the aerobic and anaerobic pathogens.

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Abdominal Computed Tomography for Postoperative Abscess: Is It Useful During the First Week?

Cited by 16 publications

References 11 publications

ACR Appropriateness Criteria® Acute Nonlocalized Abdominal Pain

ACR Appropriateness Criteria® Acute Nonlocalized Abdominal Pain

The Surgical Infection Society Revised Guidelines on the Management of Intra-Abdominal Infection

Microbiology and Management of Abdominal Infections

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