Diagnosis of Abscesses at the Resection Margin after Hepatectomy -Evaluation of Computed Tomography Appearance of Perihepatic Fluid Collection-

Shojiro Miyazaki, Ken Takasaki, Keiko Ueno*, Masashi Tsugita, Masakazu Yamamoto, Takehito Ohtsubo, Kazuyuki Takenami, Kazuhiro Akiyama, Satoshi Katagiri, Fujio Hanyuu, Yoshinori Isobe**

Department of Surgery, Radiology*, Institute of Gastroenterology,
Tokyo Women's Medical College
Department of Radiology, Kitasato University East Hospital**

Postoperative diagnosis based on computed tomography (CT) was investigated for the early recognition of intra-abdominal infectious disease following hepatectomy. This study included 159 patients in whom CT was undertaken during postoperative hospitalization, among 637 patients who had undergone hepatectomy during the 7-year period from 1987 to 1994. The CT findings of 75 patients with infection and 84 patients without infection were compared. Fluid collection at the resection margin was observed in 66 and 63 of the patients with and without infection, respectively. The significant CT findings observed in the patients with infection were (1) uneven fluid collection indicated by a high attenuation value, (2) gas in fluid collection, (3) irregularity of the fluid collection margin, (4) marginal enhancement, and (5) complications of pleural effusion. These findings were more significant in patients with hyperthermic symptoms than in those without such symptoms. The investigation of postoperative CT findings in post-hepatectomy patients makes the diagnosis of intra-abdominal infection more certain, and appears to be useful for applying treatment with drainage.

Key words
abscess at resection margin after hepatectomy, computed tomography after hepatectomy

Reprint requests
Shojiro Miyazaki Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College
8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
July 5, 1995

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