Radiology, Vol 172, 693-697, Copyright © 1989 by Radiological Society of North America
Pericholecystic abscess: classification of US findings to determine the proper therapy
T Takada, H Yasuda, K Uchiyama, H Hasegawa, T Asagoe and J Shikata
First Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Sixteen patients with a pericholecystic abscess were classified into three
groups according to the sonographic findings: Nine patients had an abscess
in the gallbladder bed, three in an intramural location in the gallbladder,
and four in an intraperitoneal cavity. In the gallbladder bed group, six
patients with a localized abscess responded well to conservative therapy,
followed by an elective operation. Two patients with a complicated abscess
were initially treated with ultrasonically (US) guided percutaneous
transhepatic gallbladder drainage and then with percutaneous transhepatic
aspiration of the liver abscess, followed by an elective operation. A
patient with a communicating abscess underwent an elective operation
because the abscess completely disappeared after percutaneous transhepatic
abscess drainage under US guidance. One of the three patients with an
intramural abscess needed an immediate operation, and the other two were
treated conservatively, followed by an elective operation. All four
patients with an intraperitoneal abscess needed an emergency operation.
Because each type of abscess received differing and successful treatments,
the authors' method of classification of US findings seemed to provide a
useful way to select the specific therapeutic procedure to achieve optimal
results.
