CT features of intraabdominal abscesses: prediction of successful percutaneous drainage

Fifty-three patients with 71 intraabdominal abscesses identified on computed tomography (CT) and treated with percutaneous abscess drainage were evaluated for the possible predictive value of any particular CT feature in relation to the outcome of percutaneous drainage. Features analyzed included the presence of a "rind," sharp exterior margin, air-fluid level, scattered internal gas bubbles, and internal septations, as well as size, site, and the presence or absence of fistulas as determined by sinography. Statistical analysis revealed that only site has predictive value; liver and subphrenic abscesses were more likely to have a successful outcome than abscesses in other locations (84% vs 47% complete cure). The presence of a long air-fluid level denoted communication with the gastrointestinal tract, which led to significantly longer drainage times and larger drainage volumes. Since there are no CT features that can strongly predict a poor outcome, all intraabdominal abscesses should be considered candidates for percutaneous drainage.