Radiologic diagnosis of an intra-abdominal abscess. Do multiple tests help?
P. B. Dobrin, P. H. Gully, H. B. Greenlee, R. J. Freeark, R. Moncada, R. Churchill, C. Reynes and R. Henkin
A review was made of the charts of 94 patients who underwent
ultrasonography (US), computed tomography (CT), and gallium citrate Ga 67
(Gall) scan to rule out intra-abdominal abscesses. Of all the clinical and
laboratory data, only the presence of pain and tenderness differentiated
patients with and without abscesses. A review of radiologic data showed
that CT was superior to US, and that US was superior to Gall scan with
regard to sensitivity, specificity, accuracy, and positive and negative
predictive values. When multiple radiologic tests were performed, results
agreed in 72% of cases; therefore, the additional tests were essentially
redundant. When radiologic test results disagreed, accuracy rates were CT,
0.86; US, 0.00; and Gall scan, 0.44. These findings suggest that, except to
rule out pelvic abscesses in the presence of pelvic inflammatory disease,
CT is usually the only special radiologic test that should be performed to
localize a suspected intra-abdominal abscess.
