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Differential diagnosis of pelvic cystic lesions caused by hemorrhage from inflammatory abscess using CT attenuation in women with acute abdomen.

Sato K, Kajihara T, Miki A, Hirabayashi E, Shintani D, Niitsu M, Ishihara O, Itakura A - Nagoya J Med Sci (2015)

Bottom Line: The preoperative CT images of the tubo-ovarian cyst were retrospectively investigated on the basis of cyst attenuation.CT attenuation of the cyst measured by both two gynecologists could be used to clearly distinguish inflammatory disease with abscess formation from bleeding disease with hematoma.This may significantly contribute to making differential diagnosis without interpretation by a medical radiologist.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan.

ABSTRACT
To determine the efficacy of computed tomography (CT) attenuation of cystic lesions measured on an image browsing system to distinguish abscess from hematoma in women with acute abdomen. The medical records of female patients of reproductive age with acute abdomen who were treated over a 7-year period in a single center and who had undergone laparotomy or laparoscopic surgery and preoperative pelvic CT scanning were retrospectively analyzed to identify those with hematoma or abscess cyst formation. Nineteen patients with tubo-ovarian abscess (abscess group) and six patients with hematoma (hematoma group) formation in the pelvis were included in the analysis. The preoperative CT images of the tubo-ovarian cyst were retrospectively investigated on the basis of cyst attenuation. CT attenuation of the cyst measured by both two gynecologists could be used to clearly distinguish inflammatory disease with abscess formation from bleeding disease with hematoma. CT attenuation on a picture archiving and communication system can distinguish hematoma from abscess in women with acute abdomen. This may significantly contribute to making differential diagnosis without interpretation by a medical radiologist.

No MeSH data available.


Related in: MedlinePlus

The preoperative CRP (mg/ml) level of the abscess group (n = 19) and the hematoma group (n = 6)
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fig1: The preoperative CRP (mg/ml) level of the abscess group (n = 19) and the hematoma group (n = 6)

Mentions: We operated 393 cases during the investigative period for suspecting gynecologic causes of acute abdomen. Among them, we were able to identify nineteen patients as ovarian abscess (abscess group) and six patients as hematoma (hematoma group) in the pelvis whose abdominopelvic CT results were also available for review. Patients’ age, BMI, preoperative WBC, and hemoglobin levels are shown in Table 1. There were no differences between the two groups in mean preoperative WBC or hemoglobin levels. The mean age of the abscess group was significantly higher than that of the hematoma group. Although the mean preoperative CRP level was significantly higher in the abscess group than in the hematoma group, there were three cases without CRP level elevation in the abscess group (Figure 1). The interval between the CT imaging and the surgery for abscess group and hematoma group ranged from 1 to 7 days (mean, 3 days) and from 1 to 2 days (mean, 1 day), respectively.


Differential diagnosis of pelvic cystic lesions caused by hemorrhage from inflammatory abscess using CT attenuation in women with acute abdomen.

Sato K, Kajihara T, Miki A, Hirabayashi E, Shintani D, Niitsu M, Ishihara O, Itakura A - Nagoya J Med Sci (2015)

The preoperative CRP (mg/ml) level of the abscess group (n = 19) and the hematoma group (n = 6)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664588&req=5

fig1: The preoperative CRP (mg/ml) level of the abscess group (n = 19) and the hematoma group (n = 6)
Mentions: We operated 393 cases during the investigative period for suspecting gynecologic causes of acute abdomen. Among them, we were able to identify nineteen patients as ovarian abscess (abscess group) and six patients as hematoma (hematoma group) in the pelvis whose abdominopelvic CT results were also available for review. Patients’ age, BMI, preoperative WBC, and hemoglobin levels are shown in Table 1. There were no differences between the two groups in mean preoperative WBC or hemoglobin levels. The mean age of the abscess group was significantly higher than that of the hematoma group. Although the mean preoperative CRP level was significantly higher in the abscess group than in the hematoma group, there were three cases without CRP level elevation in the abscess group (Figure 1). The interval between the CT imaging and the surgery for abscess group and hematoma group ranged from 1 to 7 days (mean, 3 days) and from 1 to 2 days (mean, 1 day), respectively.

Bottom Line: The preoperative CT images of the tubo-ovarian cyst were retrospectively investigated on the basis of cyst attenuation.CT attenuation of the cyst measured by both two gynecologists could be used to clearly distinguish inflammatory disease with abscess formation from bleeding disease with hematoma.This may significantly contribute to making differential diagnosis without interpretation by a medical radiologist.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan.

ABSTRACT
To determine the efficacy of computed tomography (CT) attenuation of cystic lesions measured on an image browsing system to distinguish abscess from hematoma in women with acute abdomen. The medical records of female patients of reproductive age with acute abdomen who were treated over a 7-year period in a single center and who had undergone laparotomy or laparoscopic surgery and preoperative pelvic CT scanning were retrospectively analyzed to identify those with hematoma or abscess cyst formation. Nineteen patients with tubo-ovarian abscess (abscess group) and six patients with hematoma (hematoma group) formation in the pelvis were included in the analysis. The preoperative CT images of the tubo-ovarian cyst were retrospectively investigated on the basis of cyst attenuation. CT attenuation of the cyst measured by both two gynecologists could be used to clearly distinguish inflammatory disease with abscess formation from bleeding disease with hematoma. CT attenuation on a picture archiving and communication system can distinguish hematoma from abscess in women with acute abdomen. This may significantly contribute to making differential diagnosis without interpretation by a medical radiologist.

No MeSH data available.


Related in: MedlinePlus