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January 1986

Radiologic Diagnosis of an Intra-abdominal AbscessDo Multiple Tests Help?

Author Affiliations

From the Departments of Surgery (Drs Dobrin, Greenlee, and Freeark) and Radiology (Drs Moncada, Churchill, Reynes, and Henkin), Loyola University Medical Center, Maywood, Ill, and the Department of Surgery, Hines Veterans Administration Hospital, Hines, Ill (Drs Dobrin, Greenlee, and Freeark and Ms Gully).

Arch Surg. 1986;121(1):41-46. doi:10.1001/archsurg.1986.01400010047005

• A review was made of the charts of 94 patients who underwent ultrasonography (US), computed tomography (CT), and gallium citrate Ga 67 (Gall) scan to rule out intra-abdominal abscesses. Of all the clinical and laboratory data, only the presence of pain and tenderness differentiated patients with and without abscesses. A review of radiologic data showed that CT was superior to US, and that US was superior to Gall scan with regard to sensitivity, specificity, accuracy, and positive and negative predictive values. When multiple radiologic tests were performed, results agreed in 72% of cases; therefore, the additional tests were essentially redundant. When radiologic test results disagreed, accuracy rates were CT, 0.86; US, 0.00; and Gall scan, 0.44. These findings suggest that, except to rule out pelvic abscesses in the presence of pelvic inflammatory disease, CT is usually the only special radiologic test that should be performed to localize a suspected intra-abdominal abscess.

(Arch Surg 1986;121:41-46)