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PubMed1978

[The sonographic-radiological diagnosis of abdominal abscesses (author's transl)].

The sonographic-radiological diagnosis of abdominal abscesses is discussed; these are divided into intraparenchymal, extra-parenchymal-intraperitoneal and extraparenchymal-extraperitoneal lesions. The results of grey scle sonography are most informative and are correlated with the radiological and scintigraphic findings in 25 patients. In addition to the advantages of economy and of a non-invasive method, ultrasound permits aimed fine-needle aspiration of pathological abdominal processes such as abscesses.

Abdomen↗
PubMed1976

The localization of multiple intra-abdominal abscesses by gallium scanning.

A septic course suggestive of intra-abdominal abscess followed surgery in a small child with a perforated appendix. Usual diagnostic studies, fluoroscopy, and rectal and wound exploration failed to localized an abscess. The use of gallium 67 scanning accurately localized multiple abscesses which were successfully drained.

Appendectomy↗
PubMed1979

CT as a primary diagnostic method in evaluating intraabdominal abscess.

In 19 cases, a correct diagnosis of intraabdominal abscess was made by CT body scanning. There was one false-positive diagnosis and initially one false-negative diagnosis. CT proved to be an efficient imaging method for diagnosis, for planning of therapeutic procedures, and in monitoring response to operative or conservative treatment. It has advantages over ultrasound and gallium scanning especially in severely ill, postoperative, and obese subjects. In addition, needle aspiration under CT control is readily performed and can be undertaken at the same examination. Confirmation of the diagnosis and therapeutic aspiration with or without introduction of a drainage catheter can then be undertaken.

Abdomen, Acute↗
PubMedDate not supplied

[Hepatic suppurations requiring segmented or atypical hepatectomies].

Following studies of cases with hepatic suppurations the authors indicate the necessity for regular or atypic hepatectomies. The extension of the suppurative process in the liver made necessary the ligature of the great sagital vein and the authors show, on the basis of anatomic and topographical data (hepatic segmentation), that it is necessary to extend the hepatectomy to the IV-th para-median segment. The authors also present the indications for bi-segmental right hepatectomy in segments VII-VI as well as of the total left regulated hepatectomy.

Adolescent↗
PubMed1978

Aspiration of intrathoracic abscess. Resultant acute ventilatory failure.

Three cases illustrate that acute respiratory failure may be precipitated by spontaneous drainage of lung abscess or pleural empyema intrabronchially with diffuse aspiration of the contents bilaterally. This condition is especially hazardous if the cavity is large and the patient is debilitated or obtunded. The acute onset may mimic aspiration of gastric contents. Immediate studies of tracheal aspirate and roentgenograms of the chest should define the aspiration of intrathoracic abscess contents as the cause of acute respiratory failure.

Acute Disease↗
PubMed1980

Upper abdominal abscess: a continuing and deadly problem.

Subphrenic and other upper abdominal abscesses continue to be associated with high mortality, even in today's era of broad spectrum antibiotics and sophisticated surgical techniques. Most cases represent complications of intraabdominal surgery. Because the clinical presentation is often subtle and nonspecific, the radiologist plays a paramount role in early diagnosis. Conventional radiography remains an effective method in the initial detection of upper abdominal abscesses. In this study, radiographs were reviewed in 82 patients. In retrospect, plain films revealed extraluminal gas or soft-tissue mass due to abscess in 58 patients (71%). Of these, the abscess was accurately reported initially in 42 patients, but it was initially missed in 16 patients. Conventional gastrointestinal contrast studies, which were underutilized, proved extremely accurate in demonstrating abnormality, especially in the left upper abdomen. Computed tomography, gallium scanning, and ultrasound were effective confirmatory procedures in many cases.

Abscess↗
PubMed1988

[Technic and clinical use of radioactive labelling of autologous granulocytes].

Gamma-camera imaging after injection of radiolabelled autologous leucocytes can be very helpful in the diagnosis, localization and further clinical treatment of inflammatory diseases. We present a technique allowing sterile separation of white blood cells and labelling with 99mTc-phytate or -oxine and with 111In-oxine, -oxine sulphate or -tropolone. The method is non-invasive and the radiation dose amounts to less than 80 mrad using 100 microCi 111Indium. The use of radiolabelled granulocytes is of particular diagnostic value in patients with septicaemia of unknown origin. Whole body scanning allows not only visualization of enhanced splenic uptake in septicaemia, but also localization of an inflammatory process. Preferential indications for a diagnostic approach using radiolabelled granulocytes are inflammatory abdominal processes which cannot easily be documented by means of other non-invasive techniques, such as inflammatory bowel disease (Crohn's diseases and ulcerative colitis), arthritic processes and abscesses of the liver and spleen, as well as subphrenic and retroperitoneal abscesses. Untreated osteomyelitis can be located with the help of labelled granulocytes, but in patients treated with antibiotics a false negative result is obtained in approximately 50% of cases for as yet unknown reasons, even in the presence of a still active osteomyelitic process.

Abscess↗
PubMed1978

Ultrasonography of abdominal fluid collections.

Ultrasonic examination of abdominal fluid collections sometimes allows identification of the nature of the contained fluid. Abscesses, hematomas, and lymphoceles tend to be ellipsoidal unless confined by particularly resistant structures. Abscesses often contain fine debris. Hematomas develop coarse clumps of strongly echoing material as they age. Lymphoceles have sharp walls and are echo-free. Ascites has an irregular outline, a sharply defined wall, and is echo-free. There may be bowel loops floating in it. Pseudocysts have a widely variable appearance. Bowel loopes that are distended with fluid often show peristalsis. Ultrasonically directed fine needle puncture allows confirmation of the nature of the fluid.

Abdomen↗