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December 11, 1981

Intra-abdominal Abscess: Radiological Diagnosis and Treatment

Author Affiliations

From the Departments of Radiology, Massachusetts General Hospital and the Harvard Medical School, Boston. Dr vanSonnenberg is currently with the University of California at San Diego.

JAMA. 1981;246(23):2728-2733. doi:10.1001/jama.1981.03320230052028

THE LETHAL nature of intraabdominal abscesses is evident from published rates of mortality that range from 30% in treated patients to 80% to 100% in patients with undrained abscesses.1-3 However, recent advances in diagnostic radiology have substantially altered the investigative approach and therapeutic alternatives for such patients. The new noninvasive cross-sectional imaging modalities of ultrasonography and body computed tomography (CT) have both been extremely effective diagnostic modalities for abscess detection, while radionuclide abscessimaging agents have also been introduced that demonstrate considerable accuracy in detection of septic foci, both within the abdominal cavity and in extra-abdominal locations. Finally, invasive interventional radiological techniques for percutaneous diagnostic needle-aspiration of fluid collections under ultrasonographic or CT guidance have been widely employed and can be followed by percutaneous catheter drainage for definitive non-surgical therapy. This article outlines some of the emerging trends in the diagnosis and treatment of intraabdominal abscess by radiological means.