Pediatric Abdominal Abscess

Etiology: Perforation of bowel
Imaging US: Swirling and movable internal contents and debris with compression
Imaging CT: Rim-enhancing fluid collection
DDX: Phlegmon – one way to distinguish abscess from phlegmon on US is to look for mobile contents with compression as an abscess will have liquid contents
Complications:
Treatment: Percutaneous or surgical drainage
Clinical:

Radiology Cases of Abdominal Abscess

Radiology Cases of Abdominal Abscess Due to Perforated Appendicitis

CT of abdominal abscesses — Axial CT with contrast of the abdomen and pelvis shows low density fluid collections with enhancing rims anterior to the spleen (above), in the right pelvis (middle) and posterior to the bladder and anterior to the rectum (below).

CT of pediatric distal small bowel obstruction due to perforated appendicitis resulting in two abdominal abscesses with the appendix containing two appendicoliths — Coronal CT with intravenous and oral contrast of the abdomen (left) shows a large tubular structure in the right lower quadrant that has oval high density calcified objects within its superior and inferior aspects. An oval rim enhancing fluid collection is seen lateral to this tubular structure. There is dilation of the distal ileum. The sagittal CT (right) shows a second rim enhancing fluid collection posterior to the uterus. The urine-filled normal bladder is seen anterior to the uterus.

Radiology Cases of Abdominal Abscess Due To Infected Hematoma as a Complication of Extracorporeal Membrane Oxygenation

CT of abdominal abscess in an infected hematoma — Axial (above) and coronal (below) CT with contrast of the abdomen shows an isodense oval fluid collection inferior to the liver and superior and lateral to the right kidney.