Computed tomography of pancreatic abscesses

Computed tomography (CT) was used as the primary diagnostic tool in 10 cases of pancreatic abscess and seven cases of infected pseudocyst. Pancreatic gas collections were the only definitive feature of infection and were seen in five cases (29%). An equally common finding was poorly defined nonencapsulated peripancreatic fluid collections or mottled mass density. It was not possible to distinguish infected from noninfected pseudocysts or peripancreatic fluid collections by other CT criteria. Diagnostic percutaneous needle aspiration is indicated in patients with pancreatic pseudocyst or fluid collections with persistent fever or leukocytosis. CT is also useful in the preoperative evaluation of multiple abscesses and of recurrent abscesses after surgery.