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Ultrasound and computed tomography in the diagnosis and drainage of abscesses and other fluid collections.

The indications, technique and results of percutaneous drainage in 20 patients with abscesses and other fluid collections are presented. Special emphasis is placed on the complementary use of ultrasound and computed tomography and the relative indications for the use of each. Of the 20 patients, 5 had hepatic abscesses, 7 had subphrenic or subhepatic abscesses, 3 had pancreatic pseudocysts and the remaining 5 had loculated fluid collections in either the abdomen or chest.

Abdomen↗

[Efficient procedure for diagnosing abdominal abscesses using imaging technics].

In 56 patients with abdominal abscess typical radiological abscess sings were analized to establish a rational and stepwise use of imaging procedures. Plain radiographs of the abdomen should be carried out at first because of their large diagnostic possibilities and standardized practicability. In addition with ultrasonography the diagnosis is possible in almost 90% of the cases. Contrast medium examination are rarely of diagnostic value. Computed tomography should be used in the remaining unclear cases and for planning of further surgical treatment.

Abdomen↗

Percutaneous drainage of abdominal fluid collections in children.

Percutaneous drainage of intraabdominal fluid collections was performed in 13 children. After initial diagnosis with either sonography or computed tomography, a smallbore aspiration needle (22 gauge) was guided into the collection, usually by sonography. In five patients, complete evacuation was possible using the aspirating needle alone. In seven others, the fluid was successfully drained via a catheter introduced percutaneously. In one patient, surgery was required for complete evacuation of a hematoma containing large blood clots. There were no complications.

Adolescent↗

Poor prognosis of patients with intra-abdominal sepsis and hypouricemia.

With uric acid levels of 0.4 to 3.0 milligrams per cent, hypouricemia was noted in 17 patients with intra-abdominal sepsis. This was associated with a fivefold to sixteenfold increase in the urate clearance and uric acid to creatinine clearance ratios. The number of deaths in the 17 patients with hypouricemia is 14 versus 20 for the overall group of 111 patients studied. Two patients had a reversal of the serum uric acid, 24 hour urine uric acid output and uric acid to creatinine clearance ratio, with drainage of the intra-abdominal sepsis. Hypouricemia seems to indicate a poor prognosis in patients with intra-abdominal sepsis.

Abdomen↗