Ultrasound gray-scale pattern and guided aspiration puncture of abdominal abscesses.

Various ultrasound gray-scale patterns of 45 consecutive abscesses were studied in 43 surgical and medical patients. Eleven abscess formations were unsuspected clinically, 27 had developed as a postoperative complication; 25 collections (55.6%) presented with an anechoic appearance, and 15 (33.3%) showed a mainly fluid pattern but contained a few nonreverberatory echoes. Five abscesses (11.1%) appeared with a complex solid-like pattern with large amounts of internal echoes. A total of 28 ultrasound guided diagnostic fine-needle aspirations of abscesses were performed on 26 patients without serious complications. All the aspirated samples yielded material sufficient for cytological or bacteriological examinations. Percutaneous fine-needle aspiration guided by sonography is recommended as a safe and useful diagnostic measure to confirm the nature of an ultrasonically displayed abdominal lesion suspected to be an abscess. Results from both sonography and confirmatory aspiration provide detailed topographic and diagnostic information for the choice of surgical or nonoperative management of abdominal abscess.