Bellomi M, Frigerio L F, Castoldi M C, Cozzi G, Bartoli C, Severini A
Istituto di Scienze Radiologiche, Università, Milano.
Radiol Med. 1988 Jul-Aug;76(1-2):18-22.
Abdominal abscesses as a complication of laparotomic surgery have a high mortality rate. The authors reviewed the diagnostic and therapeutic procedures of 36 patients who developed intra-abdominal abscesses after surgical treatment for abdominal neoplasias. The first-step diagnostic procedures (plain film of the abdomen and chest, CT and US) showed a sensibility of 78%. In 25/36 patients (69.5%) two interventional radiology procedures were performed: fine needle aspiration and catheter drainage of the abscess. In 16% of patients fine needle aspiration led to a complete evacuation of the abscess cavity and guaranteed the recovery. In 84% of cases a drainage catheter was positioned into the cavity and left indwelling. This case review is aimed at stressing how plain film of the abdomen is still a diagnostic procedure with high sensibility and specificity for this pathology, even though it is currently considered as a second-choice diagnostic step--US and CT being assessed as the methodologies of choice. The latter techniques can both provide a more accurate imaging when interventional radiology procedures are to be performed.
腹部脓肿作为剖腹手术的一种并发症,死亡率很高。作者回顾了36例腹部肿瘤手术治疗后发生腹腔内脓肿患者的诊断和治疗过程。第一步诊断程序(腹部和胸部平片、CT和超声)的敏感性为78%。在36例患者中的25例(69.5%)进行了两种介入放射学程序:脓肿的细针穿刺抽吸和导管引流。16%的患者通过细针穿刺抽吸实现了脓肿腔的完全排空并确保了康复。84%的病例中,将引流导管置入腔内并留置。本病例回顾旨在强调,尽管目前腹部平片被视为第二选择的诊断步骤(超声和CT被认为是首选方法),但它对这种病理状况仍然是一种敏感性和特异性较高的诊断程序。当要进行介入放射学程序时,后两种技术都能提供更准确的成像。