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. 1985 Jan 5;290(6461):23–26. doi: 10.1136/bmj.290.6461.23

Clinical importance of enteric communication with abdominal abscesses.

S H Saverymuttu, A M Peters, J P Lavender
PMCID: PMC1415409  PMID: 3917320

Abstract

The dynamics of leucocytes in abdominal abscesses were studied using indium-111 autologous leucocyte scanning in 30 patients. Thirteen patients showing enteric drainage of leucocytes on delayed scans were characterised by a lack of abdominal localising signs and a low detection rate by ultrasound (25%). By contrast, 16 of 17 patients without enteric drainage had abdominal signs, and in these patients ultrasound was associated with a higher detection rate (58%). Despite the presence of an enteric route of drainage for the abscess 10 of the 13 patients needed surgical intervention. These results help explain the wide variation in clinical presentation of abdominal abscesses; suggest that 111In leucocyte scanning should be the initial investigation in those patients without focal signs; and show that formal surgical drainage is needed in patients recognised as having enteric communication with abscesses.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Altemeier W. A., Culbertson W. R., Fullen W. D., Shook C. D. Intra-abdominal abscesses. Am J Surg. 1973 Jan;125(1):70–79. doi: 10.1016/0002-9610(73)90010-x. [DOI] [PubMed] [Google Scholar]
  2. Anderson J. R., Spence R. A., Laird J. D., Ferguson W. R., Kennedy T. L. Initial experience with indium-111 autologous leucocyte imaging in patients with acute pancreatitis. Br Med J (Clin Res Ed) 1983 Sep 3;287(6393):637–638. doi: 10.1136/bmj.287.6393.637. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Carroll B., Silverman P. M., Goodwin D. A., McDougall I. R. Ultrasonography and indium 111 white blood cell scanning for the detection of intraabdominal abscesses. Radiology. 1981 Jul;140(1):155–160. doi: 10.1148/radiology.140.1.7244219. [DOI] [PubMed] [Google Scholar]
  4. Chintapalli K., Thorsen M. K., Foley W. D., Unger G. F. Abdominal abscesses with enteric communications: CT findings. AJR Am J Roentgenol. 1983 Jul;141(1):27–28. doi: 10.2214/ajr.141.1.27. [DOI] [PubMed] [Google Scholar]
  5. Danpure H. J., Osman S., Brady F. The labelling of blood cells in plasma with 111In-tropolonate. Br J Radiol. 1982 Mar;55(651):247–249. doi: 10.1259/0007-1285-55-651-247. [DOI] [PubMed] [Google Scholar]
  6. Froelich J. W., Swanson D. Imaging of inflammatory processes with labeled cells. Semin Nucl Med. 1984 Apr;14(2):128–140. doi: 10.1016/s0001-2998(84)80026-4. [DOI] [PubMed] [Google Scholar]
  7. Fry D. E., Garrison R. N., Heitsch R. C., Calhoun K., Polk H. C., Jr Determinants of death in patients with intraabdominal abscess. Surgery. 1980 Oct;88(4):517–523. [PubMed] [Google Scholar]
  8. Gordon I., Vivian G. Radiolabelled leucocytes: a new diagnostic tool in occult infection/inflammation. Arch Dis Child. 1984 Jan;59(1):62–66. doi: 10.1136/adc.59.1.62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Peters A. M., Karimjee S., Saverymuttu S. H., Lavender J. P. A comparison of indium-111-oxine and indium-111-acetylacetone labelled leucocytes in the diagnosis of inflammatory disease. Br J Radiol. 1982 Nov;55(659):827–832. doi: 10.1259/0007-1285-55-659-827. [DOI] [PubMed] [Google Scholar]
  10. Saverymuttu S. H., Peters A. M., Hodgson H. J., Chadwick V. S., Lavender J. P. Indium-111 autologous leucocyte scanning: comparison with radiology for imaging the colon in inflammatory bowel disease. Br Med J (Clin Res Ed) 1982 Jul 24;285(6337):255–257. doi: 10.1136/bmj.285.6337.255. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Saverymuttu S. H., Peters A. M., Lavender J. P., Pepys M. B., Hodgson H. J., Chadwick V. S. Quantitative fecal indium 111-labeled leukocyte excretion in the assessment of disease in Crohn's disease. Gastroenterology. 1983 Dec;85(6):1333–1339. [PubMed] [Google Scholar]
  12. Taylor K. J., Wasson J. F., De Graaff C., Rosenfield A. T., Andriole V. T. Accuracy of grey-scale ultrasound diagnosis of abdominal and pelvic abscesses in 220 patients. Lancet. 1978 Jan 14;1(8055):83–84. doi: 10.1016/s0140-6736(78)90016-8. [DOI] [PubMed] [Google Scholar]
  13. vanSonnenberg E., Ferrucci J. T., Jr, Mueller P. R., Wittenberg J., Simone J. F., Malt R. A. Percutaneous radiographically guided catheter drainage of abdominal abscesses. JAMA. 1982 Jan 8;247(2):190–192. [PubMed] [Google Scholar]

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