Computed tomography in the diagnosis and management of abdominal abscesses

Computed tomography (CT) is effective in demonstrating abdominal abscesses and their relation to surrounding structures. The CT signs of abscess are not unlike those demonstrable radiographically and include an abnormal mass, obliteration and displacement of surrounding organs, inappropriate gas, and peripheral enhancement after intravenous contrast. Axial imaging permits selection of safe approaches through which percutaneous needle aspiration can be performed for diagnosis and therapy. When techniques similar to those employed in angiography are used, a catheter can be inserted, the abscess evacuated, and the catheter left in place as a drain. Combined with intravenous antibiotics, this method of abscess drainage has been successful in curing abscesses without surgery. Representative examples are shown.