Intraabdominal serous fluid collections after appendectomy: a normal sonographic finding.

Abstract

The significance of sonographic findings 1 week or less after appendectomy is difficult to evaluate without knowing the inconsequential abnormalities that may occur in these patients. Accordingly, we performed postoperative sonography on patients who had a normal course after appendectomy to determine the findings that can be considered normal within 1 week after surgery. Forty-four patients who had an appendectomy for acute appendicitis and who had normal findings at clinical follow-up 5 days and 6 months later were included in the study. In all patients, sonograms were obtained on the fifth postoperative day and interpreted by a radiologist who did not know the surgical findings. Ten fluid collections (23%) were found in the pericecal area, ranging in size from 10 x 10 mm to 40 x 20 mm. The collections were hypoechoic or anechoic, crescent-shaped, and immobile. Fluid collections were more common in cases of suppurative appendixes (6/20, 30%) than in cases of inflamed appendixes (4/19, 21%) and in retrocecal appendixes (3/9, 33%) than in normally located appendixes (7/34, 21%). However, the differences were not statistically significant (p > .05). Inconsequential fluid collections are detected with considerable frequency on postoperative sonograms 5 days after an appendectomy. Consequently, not every fluid collection should be considered an abscess.