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Upper abdominal abscess: a continuing and deadly problem.

T R Connell, D H Stephens, H C Carlson

    AJR. American Journal of Roentgenology
    |April 1, 1980
    PubMed
    Summary
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    Early diagnosis of upper abdominal abscesses is crucial. Conventional radiography can detect extraluminal gas or soft-tissue masses, aiding radiologists in identifying these serious conditions.

    Area of Science:

    • Radiology
    • Abdominal Imaging
    • Surgical Complications

    Background:

    • Subphrenic and upper abdominal abscesses are associated with high mortality despite advances in antibiotics and surgery.
    • These abscesses often present subtly, making early diagnosis challenging.
    • Intra-abdominal surgery is a common precursor to upper abdominal abscesses.

    Purpose of the Study:

    • To evaluate the role of conventional radiography in the initial detection of upper abdominal abscesses.
    • To assess the accuracy of plain film interpretation in identifying signs of abscess.
    • To compare the effectiveness of different imaging modalities in diagnosing upper abdominal abscesses.

    Main Methods:

    • Retrospective review of radiographs from 82 patients with suspected upper abdominal abscesses.

    Related Experiment Videos

  • Analysis of conventional gastrointestinal contrast studies.
  • Evaluation of computed tomography, gallium scanning, and ultrasound as confirmatory procedures.

    • Main Results:

    • Plain films revealed extraluminal gas or soft-tissue mass in 71% of patients (58/82).
    • Radiographs initially missed the abscess in 16 out of 58 positive cases (27.6%).
    • Gastrointestinal contrast studies were highly accurate, particularly for left upper abdominal abnormalities.

    Conclusions:

    • Conventional radiography is an effective initial tool for detecting upper abdominal abscesses, though interpretation errors can occur.
    • Gastrointestinal contrast studies are valuable and underutilized for diagnosing these abscesses.
    • Advanced imaging modalities like CT, gallium scanning, and ultrasound serve as effective confirmatory tests.