Diagnosis of abdominal abscesses with computed tomography, ultrasound, and 111In leukocyte scans.

Abstract

Computed tomography (CT), ultrasound and 111In-labeled leukocyte scans are all used in the evaluation of abdominal abscesses. Here, 170 patients in whom 1, 2 or all 3 of these modalities were used were retrospectively reviewed. Diagnostic accuracy of 96% for CT, 90% for ultrasound and 92% for 111In-labeled leukocyte scans was achieved. It was often necessary to use more than 1 modality to arrive at a correct diagnosis. The advantages, disadvantages and the causes for false positive or false negative interpretations of each of these modalities are reviewed. Analysis of the different examinations resulted in s a suggested sequence by which patients can be examined, based upon their clinical condition. Patients who are not critically ill and/or who have no localizing signs should be studied first with 111In-labeled leukocyte scans. If localizing signs are present or the patient''s condition necessitates prompt intervention, CT or ultrasound should be the 1st study performed.