Dewbury K C, Joseph A E
Dept. of Radiology, Southampton General Hospital, UK.
Scand J Gastroenterol Suppl. 1994;203:5-10. doi: 10.3109/00365529409091388.
Abdominal abscess, if left untreated, has a high mortality rate. Inadequate means of diagnosis and localization was responsible for this high mortality. Ultrasound now provides a simple non-invasive procedure permitting diagnosis with a high degree of sensitivity, although specificity is less commonly achieved. Abscesses do not have absolutely specific features, but given the appropriate clinical context and fine needle aspiration a diagnosis can be made in virtually 100% of cases, i.e. if the lesions can be identified and not obscured by bowel gas and examinations are not rendered difficult by surgical wounds and dressings. Diagnostic aspiration and therapeutic drainage are readily carried out using ultrasound guidance. Ultrasound is also of value in following the progress of lesions.
腹部脓肿若不治疗,死亡率很高。诊断和定位方法不足是导致高死亡率的原因。现在,超声提供了一种简单的非侵入性检查方法,诊断灵敏度很高,不过特异性则较难实现。脓肿没有绝对的特异性特征,但在适当的临床背景下,结合细针穿刺抽吸,几乎在100%的病例中都能做出诊断,也就是说,如果能识别出病变,且病变未被肠气遮挡,检查也未因手术伤口和敷料而变得困难。在超声引导下可轻松进行诊断性抽吸和治疗性引流。超声在跟踪病变进展方面也很有价值。