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Abscesses with enteric communication: a potential pitfall in computed tomography.
Journal of Computer Assisted Tomography
|May 1, 1987
Summary
Computed tomography (CT) missed abdominal abscesses in six of 17 patients due to misinterpretation of fluid collections. Plain radiography showed suggestive findings in nearly half of cases, including some CT false-negatives.
Area of Science:
- Radiology
- Gastroenterology
- Abdominal Imaging
Background:
- Abdominal abscesses with enteric communication present diagnostic challenges.
- Computed tomography (CT) is a primary imaging modality for diagnosing abdominal abscesses.
Purpose of the Study:
- To evaluate the diagnostic accuracy of CT in identifying abdominal abscesses with enteric communication.
- To identify reasons for CT misdiagnosis in these cases.
Main Methods:
- Retrospective review of clinical and radiologic records of 17 patients with proven abdominal abscesses and enteric communication.
- Analysis of CT scans and plain abdominal radiography findings.
Main Results:
- CT correctly diagnosed abdominal abscesses in 11 out of 17 patients (65%).
- Six cases were misdiagnosed by CT due to fluid collections mimicking bowel loops (near water density, gas/fluid-filled, or contrast-filled).
- Plain radiography revealed suggestive findings in 48% of patients, including two CT false-negatives.
Conclusions:
- CT has limitations in diagnosing abdominal abscesses with enteric communication, particularly when fluid collections resemble bowel loops.
- Plain radiography can provide valuable complementary information in suspected cases.
- Careful interpretation of imaging is crucial to avoid misdiagnosis in complex abdominal abscess presentations.