Abstract
While classic teaching dictates computed tomography (CT) for postoperative abdominal or pelvic abscess in the first week is of low yield, little evidence supports intentional delays in imaging for suspected abscess. This retrospective review examined all CT scans obtained for clinical suspicion of abscess between 3 and 30 days after abdominal or pelvic operation over a 3-year period. Scans were grouped into those obtained between 3 and 7 days after surgery (EARLY) and those obtained after day 7 (LATE). Diagnostic yield was compared between EARLY and LATE groups. Of 262 CT examinations (EARLY, n=106; LATE, n=156), 71 studies (27%) demonstrated abscess. There was no significant difference in the diagnostic yield of CT for abscess between EARLY and LATE groups (23% [24 of 106] versus 30% [47 of 156], P=0.18). Of patients with an abscess, 63% (45 of 71) underwent percutaneous or operative drainage (EARLY 75% [18 of 24], LATE 57% [27 of 47], P=0.15). Abdominal CT for postoperative abscess can be expected to be diagnostic in a substantial proportion of cases in the first week, the majority of which lead to percutaneous or operative drainage. Postoperative CT for intra-abdominal abscess should be obtained as clinically indicated, regardless of interval from surgery.
Similar content being viewed by others
References
Kumar V, Fausto N, Abbas A. Robbins and Cotran Pathologic Basis of Disease, 7th ed. Philadelphia: WB Saunders, 2004.
Callen PW. Computed tomographic evaluation of abdominal and pelvic abscesses. Radiology 1979;131:171–175.
Kleinhaus U, Goldsher D, Kaftori JK. Computed tomographic diagnosis of abdominal abscesses. Radiologie 1982;22:230–234.
Fry DE. Noninvasive imaging tests in the diagnosis and treatment of intra-abdominal abscesses in the postoperative period. Surg Clin North Am 1994;74:693–709.
Connell TR, Stephens DH, Carlson HC, Brown ML. Upper abdominal abscess: A continuing and deadly problem. AJR Am J Roentgenol 1980;134:759–765.
Dobrin PB, Gully PH, Greenlee HB, Freeark RJ, Moncada R, Churchill R, Reynes C, Henkin R. Radiologic diagnosis of an intra-abdominal abscess. Do multiple tests help? Arch Surg 1986;121:41–46.
Saini S, Kellum JM, O’Leary MP, O’Donnell TF, Tally FP, Carter B, Deterling RA, Curtis LE. Improved localization and survival in patients with intra-abdominal abscesses. Am J Surg 1983;145:136–142.
Khurrum BM, Hua ZR, Batista O, Uriburu JP, Singh JJ, Weiss EG, Nogueras JJ, Wexner SD. Percutaneous postoperative intra-abdominal abscess drainage after elective colorectal surgery. Tech Coloproctol 2002;6:159–164.
Marano I, Mainenti PP, Selva G, Cannavale M, Sodano A. Computerized tomography-guided drainage of postoperative abdominal fluid collections. Radiol Med 1999;97:160–165.
Vadala G, Caragliano V, Castorina R, Caragliano L, Caragliano P. An update on the treatment of intra-abdominal abscesses. Minerva Chir 1999;54:245–250.
Wolverson MK, Jagannadharao B, Sundaram M, Joyce PF, Riaz MA, Shields JB. CT as a primary diagnostic method in evaluating intra-abdominal abscess. AJR Am J Roentgenol 1979;133:1089–1095.
Norwood SH, Civetta JM. Abdominal CT scanning in critically ill surgical patients. Ann Surg 1985;202:166–175.
Tsai SC, Chao TH, Lin WY, Wang SJ. Abdominal abscesses in patients having surgery: An application of Ga-67 scintigraphic and computed tomographic scanning. Clin Nucl Med 2001;26:761–764.
Iannoli P, Sax HC. Abdominal adhesions. In: Cameron JL, ed. Current Surgical Therapy, 7th ed. St. Louis: Mosby, 1998, pp 174–177.
Bass KN, Bulkley GB. Small bowel obstruction. In: Cameron JL, ed. Current Surgical Therapy, 6th ed. St. Louis: Mosby, 1995, pp 122–131.
Author information
Authors and Affiliations
Corresponding author
Additional information
The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, the Department of Defense, or the United States Government.
Rights and permissions
About this article
Cite this article
Antevil, J.L., Egan, J.C., Woodbury, R.O. et al. Abdominal computed tomography for postoperative abscess: Is it useful during the first week?. J Gastrointest Surg 10, 901–905 (2006). https://doi.org/10.1016/j.gassur.2005.12.006
Issue Date:
DOI: https://doi.org/10.1016/j.gassur.2005.12.006