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Impact of CT-Guided Drainage in the Treatment of Diverticular Abscesses: Size Matters

Bettina Siewert1, Grace Tye1, Jonathan Kruskal1, Jacob Sosna1 and Frank Opelka2

1 Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02115.
2 Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02115.


Figure 1
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Fig. 1A —57-year-old woman with large diverticular abscess. Axial CT image shows 4.9-cm abscess (arrow) containing air-fluid level.

 

Figure 2
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Fig. 1B —57-year-old woman with large diverticular abscess. Axial CT image from CT-guided catheter drainage confirms adequate catheter position (arrow) and complete aspiration of abscess at time of examination.

 

Figure 3
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Fig. 1C —57-year-old woman with large diverticular abscess. On axial CT image 22 days later, there is reaccumulation of abscess (arrow) that was again treated with CT-guided catheter drainage.

 

Figure 4
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Fig. 2A —45-year-old man with large diverticular abscess. Axial CT image shows 3.8-cm intramural abscess (arrow) with enhancing wall. Patient was treated with antibiotics because abscess was inaccessible to percutaneous catheter drainage.

 

Figure 5
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Fig. 2B —45-year-old man with large diverticular abscess. Follow-up CT examination 21 days later shows complete resolution of abscess and inflammatory changes of colon.

 

Figure 6
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Fig. 3A —55-year-old woman with diverticular abscess. Axial CT image shows 2.0-cm abscess (arrow) with enhancing rim containing predominantly air. Patient was treated with antibiotics.

 

Figure 7
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Fig. 3B —55-year-old woman with diverticular abscess. Axial image cranial in relation to A shows changes of diverticulitis with asymmetric wall thickening (arrow) and adjacent fat stranding.

 

Figure 8
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Fig. 3C —55-year-old woman with diverticular abscess. On follow-up CT after 25 days, abscess and inflammatory changes of colon have completely resolved.

 

Figure 9
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Fig. 4 —57-year-old man with diverticular abscess. Axial CT image shows 1.7-cm abscess (arrow) with enhancing wall. Patient was treated with antibiotics and symptoms resolved on clinical follow-up.

 

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