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.

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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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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Copyright © 2006 by the American Roentgen Ray Society.