CT IN SEARCHING FOR ABSCESS AFTER ABDOMINAL OR PELVIC-SURGERY IN PATIENTS WITH NEOPLASIA - DO ABDOMEN AND PELVIS BOTH NEED TO BE SCANNED

Purpose: This prospective study was undertaken to determine the increm ental yield of combined abdominal and pelvic CT in searching for clini cally suspected postoperative abscess in oncologic patients. Method: O ne hundred seventeen oncologic patients underwent CT to exclude a clin ically suspected abscess within 30 days of abdominal or pelvic surgery during an 8 month period. Scans were evaluated for the presence of as cites, loculated fluid collections, or other possible sources of fever . The clinical course and any intervention in the abdomen or pelvis wi thin 30 days after CT were recorded. Results: After abdominal surgery, 44 of 69 [64%; confidence interval (CI) 51-75%] patients had loculate d fluid collections in the abdomen; no patient (0%; CI 0-5%) had a loc ulated fluid collection present only in the pelvis. After pelvic surge ry, 22 of 48 (46%; CI 31-61%) patients had loculated fluid collections in the pelvis; no patient (0%; CI 0-7%) had a loculated collection pr esent only in the abdomen. Loculated collections were present in both the abdomen and the pelvis in 4 of 69 (6%; CI 1.6-14%) patients after abdominal surgery and 3 of 48 (6%; CI 1.3-17%) after pelvic surgery. C onclusion: Isolated pelvic abscesses after abdominal surgery and isola ted abdominal abscesses after pelvic surgery appear to be very uncommo n in oncologic patients. CT initially need be directed only to the reg ion of surgery in this particular patient population.