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NewYork-Presbyterian Hospital Psychiatry
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Case of the Month 03/2017

This 72 year old male with bladder cancer s/p ileoureteral conduit presented to the ED complaining of fever and abdominal pain.

Question 1 : What’s wrong with this pictures?


View answer
Answer 1:

There is a large fluid collection just anterior to the right psoas muscle (see circle below.)


Question 2: Which is the ideal way to order a CT to see an intra-abdominal abscess? What findings are you looking for?
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Answer 2:

A CT scan with both oral and IV contrast would be preferred. Oral contrast helps differentiate structures from within and outside of the intestine. It may also help reveal the presence of a fistula or other disruption of the bowel wall. IV contrast may enhance the abscess by concentrating the contrast material within the abscess wall. In a study without contrast such as this, fat-stranding around around the abscess is a key finding.

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