Kumpan W
Radiologe. 1987 May;27(5):203-15.
100 patients with 140 abdominal abscesses were included in this study: 113 occurred intraperitoneal, 85% of these postoperatively, 15% spontaneously and in 11.5% the retroperitoneal space was affected concomitantly. In the postoperative group multilocular disease (= more than one typical compartment affected) was much more frequent when compared to spontaneous abscesses. Surgery with peritoneal barrier changes resulted in formation of new and "atypical" abdominal compartments which were the site of 39% of postoperative abscesses in this series. Communications of the lesser sac with the left subphrenic space were most frequently involved, followed by the fused right subphrenic and subhepatic space, when the coronary ligament was disconnected operatively. Knowledge of surgically induced changes of normal abdominal anatomy and its role for abscess formation and propagation may be very essential for correct CT-localization and CT-guided drainage.
本研究纳入了100例患有140个腹部脓肿的患者：113个脓肿发生在腹腔内，其中85%是术后发生的，15%是自发形成的，11.5%的患者同时伴有腹膜后间隙受累。与自发脓肿相比，术后组的多房性病变（即不止一个典型腔隙受累）更为常见。伴有腹膜屏障改变的手术导致形成新的“非典型”腹腔间隙，本系列中39%的术后脓肿发生于此。当冠状韧带手术切断时，网膜囊与左膈下间隙的连通最常受累，其次是融合的右膈下和肝下间隙。了解手术引起的正常腹部解剖结构变化及其在脓肿形成和扩散中的作用，对于正确的CT定位和CT引导下引流可能非常重要。
