Postoperative fluid collections after colon resection: the utility of clinical assessment

BackgroundComputed tomography (CT) scans often identify postoperative fluid collections of uncertain clinical relevance.MethodsConsecutive adult patients undergoing colorectal resection and postoperative CT scan from January 1, 2000 to December 31, 2008, at a university teaching hospital were identified from a prospective database. A host of clinical and CT findings were recorded. Fisher's exact test and logistic regression with univariate and multivariate analysis were used to assess the predictive value of clinical and radiologic variables.ResultsNine hundred six patients had a colon resection during the study period. Fifty-four patients had a postoperative fluid collection, of which 36 were found to be abscesses. Only high clinical suspicion of an abscess predicted the presence of an abscess (P = .009); of the radiologic criteria, only proximity to the anastomosis was predictive (P = .05).ConclusionsClinical judgment is superior to radiologic and individual clinical parameters. This finding has the potential to prevent many unnecessary procedures.