The purpose of this study is to evaluate CT imaging findings that may suggest superinfection of abdominal fluid collections. A prompt diagnosis is fundamental for allowing timely and appropriate medical management, reducing duration of hospitalization and decreasing mortality, which can reach 100% in patients not properly treated.

In this retrospective study, we included 38 patients (25 males, 13 females; mean age 63.5 years) with intra-abdominal collections. These collections presented different etiologies, 19 resulting frompost-operative conditions (major cause: distal pancreatectomy observed in 7/19 patients) and 19 resulting from inflammatory conditions (major cause: acute necrotizing pancreatitis observed in 11/19 patients).For each collection, 2 different readers evaluated the diagnostic CT for the presence of gas, the density of the content in Hounsfield units and the wall enhancement. All patients underwent drainage of their collection under...

24/38 (63.1%) collections were infected and 14/38 (36.9%) were not.Gas was present in 17/38 (44.7%) collections, all the patients presenting this finding resulted infected. 21/38 (55.3%) collections did not show any presence of gas, of these 14/21 (66.6%) were not infected, while 7/21 (33.4%) were infected. All the infected collection without gas were caused by anaerobes micro-organisms. In our experience, therefore, we confirmed a strong correlation between the presence of air in the collection and the process of superinfection (p = 0.0001). Gas in the...

In our experience, the only factor predictive of superinfection was the presence of gas in the collection. The limited sensitivity of this radiological finding nevertheless cannot exclude a superinfection process if gas bubbles are not found into a collection. No significant differences of density and wall enhancement were observed between infected and non-infected collections, making these parameters useless in the evaluation of superinfection in abdominal collections.

M. Gasparetto; Verona/IT - nothing to disclose L. Costa; Verona/IT - nothing to disclose A. Mazzaro; Verona/IT - nothing to disclose G. Zamboni; Verona/IT - nothing to disclose G. Mansueto; Verona/IT - nothing to disclose

Diagnostic accuracy of intra-abdominal fluid collection characterization in the era of multidetector computed tomography.Allen BC1,Barnhart H,Bashir M,Nieman C,Breault S,Jaffe TA.