Abdominal computed tomography for postoperative abscess: is it useful during the first week?

Area of Science:

• Radiology
• Surgical Oncology
• Abdominal Imaging

Background:

• Classic teaching suggests low yield for early postoperative computed tomography (CT) in detecting abdominal or pelvic abscess.
• Limited evidence supports delaying imaging for suspected postoperative abscesses.

Purpose of the Study:

• To evaluate the diagnostic yield of CT for suspected postoperative abdominal or pelvic abscess within the first week compared to later imaging.
• To determine if early CT scans lead to timely interventions.

Main Methods:

• Retrospective review of 262 CT scans for suspected abscesses within 3 to 30 days post-abdominal or pelvic surgery.
• Scans were categorized into early (3-7 days) and late (after 7 days) groups.
• Diagnostic yield and intervention rates were compared between groups.

Main Results:

• Overall abscess detection rate was 27% (71 of 262).
• No significant difference in diagnostic yield between early (23%) and late (30%) CT groups (P=0.18).
• Abscesses identified in the early group had a higher rate of percutaneous or operative drainage (75% vs. 57%).

Conclusions:

• Computed tomography (CT) is diagnostically effective for postoperative abdominal or pelvic abscesses within the first week.
• Clinical indication, not the timing of imaging post-surgery, should guide CT use for suspected abscess.
• Early detection via CT facilitates prompt drainage interventions.