EURORAD ESR

Case 14321

Cold Abscess of the Anterior Abdominal Wall: An Unusual Primary Presentation

Author(s)
Patel Mitulkumar, Padmani Shailesh, Desai Purvi.

Concept diagnostic and imaging center, Near Sosyo circle, Surat 395002, India. Email:mitul_202000@yahoo.co.in
 
Patient
male, 45 year(s)
 
 
  • Figure 1
    ABDOMINAL ULTRASOUND
     

    Large abdominal parietal wall mass (predominantly cystic) of mixed echogenicity, with irregular walls and liquefied necrotic center with coarse internal echoes. Lesion shows posterior acoustic enhancement.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Acute;

    Lesion is seen indenting underlying left lobe of liver.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Acute;

    Lesion appears hypovascular on colour doppler.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Acute;

    Lesion shows coarse internal echoes.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 2
    PLAIN CT ABDOMEN

    Loculated cystic fluid density collection with scattered engulfed fat density areas in it, involving the rectus sheath of the anterior abdominal wall in epigastric region overlying left lobe of liver. No evidence of...

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 3
    CONTRAST ENHANCED CT ABDOMEN
     

    Peripherally enhancing cystic fluid density collection in anterior abdominal wall in epigastric lesion. Lesion shows enhancing internal septa and scattered engulfed fat density areas in it.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Lesion is seen indenting underlying left lobe of liver.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Significant thickening of overlying skin and subcutaneous tissue. Lesion involves rectus sheath and rectus abdominis muscle.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Insinuation of collection along falciform ligament and ligamentum venosum reaching upto porta hepatis, compressing left branch of portal vein.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 4
    Reconstructed images
     

    Fairly large peripherally enhancing loculated cystic fluid density collection in anterior abdominal wall in epigastric lesion.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Significant thickening of overlying skin and subcutaneous tissue.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Insinuation of collection along falciform ligament.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Lesion shows enhancing internal septa and scattered engulfed fat density areas in it.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
Large abdominal parietal wall mass (predominantly cystic) of mixed echogenicity, with irregular walls and liquefied necrotic center with coarse internal echoes. Lesion shows posterior acoustic enhancement.
 
Lesion is seen indenting underlying left lobe of liver.
 
Lesion appears hypovascular on colour doppler.
 
Lesion shows coarse internal echoes.
 
Loculated cystic fluid density collection with scattered engulfed fat density areas in it, involving the rectus sheath of the anterior abdominal wall in epigastric region overlying left lobe of liver. No evidence of calcification.
 
Peripherally enhancing cystic fluid density collection in anterior abdominal wall in epigastric lesion. Lesion shows enhancing internal septa and scattered engulfed fat density areas in it.
 
Lesion is seen indenting underlying left lobe of liver.
 
Significant thickening of overlying skin and subcutaneous tissue. Lesion involves rectus sheath and rectus abdominis muscle.
 
Insinuation of collection along falciform ligament and ligamentum venosum reaching upto porta hepatis, compressing left branch of portal vein.
 
Fairly large peripherally enhancing loculated cystic fluid density collection in anterior abdominal wall in epigastric lesion.
 
Significant thickening of overlying skin and subcutaneous tissue.
 
Insinuation of collection along falciform ligament.
 
Lesion shows enhancing internal septa and scattered engulfed fat density areas in it.
 
 
 
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