Die Treffsicherheit des Ultraschalls beim Nachweis intraabdomineller Abszeßbildungen

Abstract

During the last two years 73 patients with a total number of 84 abdominal abscesses have been investigated by ultrasound. Two thirds of the patients (67%) had postoperative abscesses. Spontaneous abscesses occurred in the remaining 33%. Multiple abscesses occurred in the postoperative group only (7 patients). The overall sensitivity in detecting an abscess was 84%. The sensitivity was much better with spontaneous abscesses (92%) than with postoperative abscesses (80%). One third of the patients have also been investigated by computed tomography. The diagnosis was confirmed either by needle aspiration or by operative drainage. Ultrasound was most useful in detecting abscesses in the right and left upper quadrant and in the pelvis, while CT was superior in the mid-abdomen and when dealing with multiple abscesses.

CT-Guided Percutaneous Drainage and Fluid Aspiration in Intensive Care Patients

“…Additionally, in postoperative or traumatized patients distension of the bowel by gas may preclude adequate US imaging. Similarly, wounds, dressings, and tubes may reduce accuracy (4,6,8,14,16,19). The sensitivity of CT in detecting abscesses is well established and is reported to be as high as 88% to 100% (4,(14)(15)(16).…”

“…Nevertheless, only a few reports deal with percutaneous catheter drainage in critically ill or in intensive care unit (ICU) patients (2,10,17,24,26). The value of ultrasonography (US) in diagnosing abscesses has repeatedly been emphasized, but the procedure-related problems are also well known (2,4,6,8,10,13,14,16,17,19,21,23). When US fails to demonstrate a pathologic fluid collection and clinical suspicion remains high, CT is indicated (4,6,8,19).…”

CT-Guided Percutaneous Drainage and Fluid Aspiration in Intensive Care Patients

“…Traditional surgeons tend to operate but the mortality in septic patients undergo ing reoperation is exceedingly high (13,18,19,23) According to the literature abscess formations of more than 3 cm in diameter should be detected by US (2). The sensitivity in visualizing abscesses by US varies between 44% and 84% depending on abscess location (4,6,8,14,16,21). Abscesses adjacent to the bowel or pancreas, or in the left subphrenic space after splenectomy, may be difficult to assess by US.…”

“…Additionally, in postoperative or trauma tized patients distension of the bowel by gas may preclude adequate US imaging. Similarly, wounds, dressings, and tubes may reduce accuracy (4,6,8,14,16,19). The sensitivi ty of CT in detecting abscesses is well established and is reported to be as high as 88% to 100% (4,(14)(15)(16).…”

“…Neverthe less, only a few reports deal with percutaneous catheter drainage in critically ill or in intensive care unit (ICU) patients (2,10,17,24,26). The value of ultrasonography (US) in diagnosing abscesses has repeatedly been empha sized, but the procedure-related problems are also well known (2,4,6,8,10,13,14,16,17,19,21,23). When US fails to demonstrate a pathologic fluid collection and clinical suspicion remains high, CT is indicated (4,6,8,19).…”