Abscesses with enteric communication: a potential pitfall in computed tomography

We retrospectively reviewed the clinical and radiologic records of 17 patients with proven abdominal abscesses with enteric communication. Computed tomography was able to correctly diagnose an abdominal abscess in only 11 of these 17 patients. The six patients whose abscesses were missed with CT fell into three categories. Two patients had near water density fluid collections mistaken for fluid-filled loops of bowel. Two patients had large gas and fluid-filled collections mistaken for bowel, and two patients had collections containing a large amount of orally administered contrast material that were mistaken for contrast-filled loops of bowel. Retrospective examination of plain abdominal and/or digital scout radiography revealed findings suggestive of an abscess in 48% of the 17 patients, including two of the six CT false-negatives.