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[Echo morphology and puncture diagnosis of intraabdominal abscesses]
Abstract:
In this article it is reported about 35 intraabdominal abscesses, which were sonographically diagnosed in 32 patients. 22 times the diagnosis could be proven with percutaneous fine-needle-aspiration guided by ultrasound, five of them had a sonographically guided percutaneous abscess drainage, while 7 only could be diagnosed by operation. The sonomorphologic criteria of intraabdominal abscesses are polymorphous. Therefore we could subdivide the abscesses into five types according to their different echogeneity. Probes of pus, won by percutaneous five-needle-aspiration, were examined under experimental conditions in a waterbath. The sonomorphologic appearance is comparable to the in-situ-situation. Our experiments showed, that the echogeneity of intraabdominal abscesses is based on echogenic microbubbles besides echoforming detritus and protein-bodies. The polymorphous sonographic appearance of intraabdominal abscess formation and the well known problems of differential diagnosis gives percutaneous, sonographically guided fine-needle-aspiration an important position.
Insights
Ultrasound (US) effectively diagnoses intraabdominal abscesses. Fine-needle aspiration guided by US is crucial for confirming diagnoses and guiding treatment, overcoming challenges in differentiating abscess types.
Area of Science:
- Radiology
- Gastroenterology
- Surgical Pathology
Context:
- Intraabdominal abscesses present diverse sonographic appearances, complicating diagnosis.
- Accurate and timely diagnosis is essential for effective patient management.
- Ultrasound is a primary imaging modality for evaluating abdominal pathologies.
Purpose:
- To investigate the sonomorphologic criteria of intraabdominal abscesses.
- To correlate experimental findings with clinical ultrasound observations.
- To evaluate the role of percutaneous fine-needle aspiration in abscess diagnosis.
Summary:
- This study reports on 35 intraabdominal abscesses in 32 patients diagnosed using ultrasound.
- Ultrasound revealed polymorphous sonomorphologic criteria, leading to a five-type classification based on echogenicity.
- Percutaneous fine-needle aspiration, guided by ultrasound, confirmed the diagnosis in 22 cases.
- Experimental analysis of abscess pus revealed echogenic microbubbles, detritus, and protein bodies as key factors in echogenicity.
- Ultrasound-guided fine-needle aspiration is highlighted as a valuable tool due to the varied appearance and diagnostic challenges of intraabdominal abscesses.
Impact:
- Establishes echogenic microbubbles, detritus, and protein bodies as determinants of intraabdominal abscess echogenicity.
- Reinforces the importance of ultrasound-guided fine-needle aspiration in diagnosing complex intraabdominal abscesses.
- Provides a classification system for sonomorphologic variations in intraabdominal abscesses, aiding differential diagnosis.