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Postoperative fluid collections after colon resection: the utility of clinical assessment

Authors
Journal
The American Journal of Surgery
0002-9610
Publisher
Elsevier
Volume
206
Issue
4
Identifiers
DOI: 10.1016/j.amjsurg.2013.01.031
Keywords
  • Abscess
  • Ct Scan
  • Colon Resection
  • Fluid Collection
Disciplines
  • Education
  • Medicine

Abstract

Abstract Background Computed tomography (CT) scans often identify postoperative fluid collections of uncertain clinical relevance. Methods Consecutive adult patients undergoing colorectal resection and postoperative CT scan from January 1, 2000 to December 31, 2008, at a university teaching hospital were identified from a prospective database. A host of clinical and CT findings were recorded. Fisher's exact test and logistic regression with univariate and multivariate analysis were used to assess the predictive value of clinical and radiologic variables. Results Nine hundred six patients had a colon resection during the study period. Fifty-four patients had a postoperative fluid collection, of which 36 were found to be abscesses. Only high clinical suspicion of an abscess predicted the presence of an abscess (P = .009); of the radiologic criteria, only proximity to the anastomosis was predictive (P = .05). Conclusions Clinical judgment is superior to radiologic and individual clinical parameters. This finding has the potential to prevent many unnecessary procedures.

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