Radiologic Diagnosis of an Intra-abdominal Abscess

Dobrin, Philip B.; Gully, Patricia Heer; Greenlee, H.; Freeark, Robert J.; Moncada, Rogelio; Churchill, Robert; Reynes, Carlos J.; Henkin, Robert E.

doi:10.1001/archsurg.1986.01400010047005

Cited by 56 publications

(23 citation statements)

References 10 publications

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“…Sensitivity of 90-100% has been reported in many studies [8,9,10,11]. This compares with an ultrasound sensitivity of 80-85% [8,12] in experienced hands.…”

Section: Computed Tomographymentioning

confidence: 88%

Non-traumatic abdominal emergencies: imaging and intervention in sepsis

Lee

2002

Eur Radiol

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Cross-sectional imaging, in particular CT, has become the main method of detecting abdominal collections. Indium-labelled white-cell scintigraphy and gallium scintigraphy are reserved for patients in whom there is a high clinical suspicion of abdominal sepsis but CT has not revealed a source of sepsis. Scintigraphy is also used in patients with suspected vascular graft infections or suspected infected hip prostheses. Percutaneous abscess drainage (PAD) has revolutionised the treatment of abdominal abscesses over the past 20 years, with repeat laparotomy for postoperative abscesses becoming a rare event. Ultrasound or CT can be used to guide PAD. Choosing an access route that does not cross intervening organs is of crucial importance to the safe performance of PAD. The Trocar or Seldinger techniques can be used with equal success. The cavity should be aspirated until dry and irrigated with saline. Repeat imaging after drainage is helpful to detect any undrained locules. PAD endpoints include patient defervescence, reduction in white blood cell count and catheter drainage of less than 10 ml per day. Details regarding PAD in specific abdominal regions are discussed. Success rates for PAD are high (close to 90%) in most abdominal organs. Slightly lower success rates are seen with PAD of pancreatic abscesses and abscesses associated with fistulas (60-85% success rates). Complication rates lie between 0% and 10%. Complications can be minimised by ensuring that the patient has broad spectrum antibiotic coverage before drainage, by carefully planning the access route and by ensuring diligent post-procedure care by radiology staff.

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“…Sensitivity of 90-100% has been reported in many studies [8,9,10,11]. This compares with an ultrasound sensitivity of 80-85% [8,12] in experienced hands.…”

Section: Computed Tomographymentioning

confidence: 88%

Non-traumatic abdominal emergencies: imaging and intervention in sepsis

Lee

2002

Eur Radiol

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“…Early diagnosis followed by appropriate operative surgical procedures and drainage is the key to managing patients with serious intra-abdominal infections. Most reports agree that computed tomography (CT) is the imaging method of choice for the diagnosis of intra-abdominal abscesses [17,18]. However, in patients with distortion of normal anatomy due to recent trauma or surgery, an early infection before the development of discrete fl uid collections is more diffi cult to detect with CT.…”

Section: Discussionmentioning

confidence: 99%

The value of Tc-99m (V) dimercaptosuccinic acid in detecting intra-abdominal infection: compared with gallium scan

2007

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“…2 The most specific sign of abscess on CT is extraluminal air within a fluid collection resulting from bacterial gas formation, 2,4 although this finding is seen in only 50% of IAAs. Surgery is the most common etiology of IAA, 5 which is best diagnosed with CT. 4,6,7 CT is also central to effective management, as image-guided percutaneous drainage has emerged as the treatment of choice for the vast majority of postoperative IAA. [8][9][10][11] Because the imaging features that differentiate an organized abscess from a simple fluid collection are time dependent, the utility of CT for IAA is thought to be low before the second postoperative week.…”

Section: Discussionmentioning

confidence: 99%