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Computed tomography and post-laparotomy intra-abdominal abscesses

P Trunet, J R Le Gall, P L Fagniez

    Intensive Care Medicine
    |January 1, 1982
    PubMed
    Summary
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    Computed tomography (CT) effectively diagnoses post-laparotomy sepsis complications like abscesses in critically ill patients. This imaging method aids in precise localization, enabling less invasive treatments and improving patient outcomes.

    Area of Science:

    • Radiology
    • Surgical Oncology
    • Critical Care Medicine

    Background:

    • Post-operative sepsis following laparotomy presents diagnostic challenges, particularly in ventilated, critically ill patients.
    • Early and accurate diagnosis is crucial for effective management and to avoid extensive surgical re-intervention.

    Purpose of the Study:

    • To evaluate the diagnostic accuracy and clinical utility of abdominal computed tomography (CT) in identifying abscesses in patients with post-laparotomy sepsis.
    • To assess the role of CT in guiding treatment strategies, specifically in avoiding extensive laparotomies.

    Main Methods:

    • A prospective study of 31 patients with suspected post-laparotomy sepsis who underwent abdominal computed tomography (CT).
    • Analysis of CT findings for abscess detection and localization, correlated with clinical outcomes.

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  • Calculation of diagnostic accuracy, sensitivity, and specificity.

    • Main Results:

    • Computed tomography (CT) successfully diagnosed and localized abscesses in 15 out of 31 patients.
    • In patients without abscesses, CT was negative in 14 cases, with two false positives.
    • The overall accuracy of CT was 0.94, with a sensitivity of 1 and a specificity of 0.88.

    Conclusions:

    • Abdominal computed tomography (CT) is a highly accurate, non-invasive tool for diagnosing post-laparotomy sepsis and identifying intra-abdominal abscesses.
    • CT enables precise lesion localization, facilitating limited surgical drainage and potentially avoiding extensive laparotomy.
    • The ability to screen the entire abdomen makes CT invaluable in managing critically ill surgical patients.