What is needed from imaging? The surgeon's point of view.

Abdominal sepsis after surgery is decreasing in incidence but has a high mortality, especially in those with other complicating factors. The most difficult abscesses to localize are those in intermesenteric folds. Pyrexia of unknown origin is much less of a clinical problem since the advent of ultrasound and computerized tomography (CT) scanning. Laparotomy still has an occasional role but laparoscopy should precede it and may be therapeutic using minimally invasive surgical techniques; for example, in appendicitis and cholecystitis. Pancreatitis remains a serious clinical problem in which imaging plays an important role. Percutaneous drainage has a similar morbidity and success rate to open drainage. In certain cases of diverticular disease it may obviate altogether the need for surgical resection. The differentiation between abscess and necrotic tumour is important, and CT is most helpful in this area.