Unexpected subdiaphragmatic findings on CT of the chest in septic patients after cardiac surgery.
OBJECTIVE
to draw the attention to upper abdominal abnormalities, which may be revealed incidentally in patients referred for a chest computed tomography (CT) after cardiac surgery.


METHODS
We reviewed prospectively and retrospectively the CT results of all patients referred for a chest CT, with suspected sternal infection or for other reasons, after cardiac surgery, to assess possible upper abdominal disease as visualized on lower cuts of the chest CT with abdominal windows.


RESULTS
Out of a total of 205 patients in the study 39 (19%) had unexpected abdominal abnormalities. The organs involved in decreasing order of frequency were the spleen (n = 18), gallbladder (n = 15), pancreas (n = 9), kidneys (n = 6) and bowel (n = 3). Many patients had involvement of more than one organ. The lesions were mainly ischaemic and/or infectious in origin. These findings led to interventional procedures in 13 (33%) of the patients with a good outcome.


CONCLUSIONS
We found a relatively high prevalence of abdominal abnormalities on CT of the chest in patients referred with suspected thoracic problems after cardiac surgery. Major findings on CT led to changes in the management of these patients. We recommend therefore viewing lung bases with abdominal windows as well as adding sections through the upper abdomen in patients who are referred for a chest CT after cardiac surgery with suspected thoracic problems.
Apter
Sara
S
Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel.
Amir
Gabriel
G
Taler
Michael
M
Gayer
Gabriela
G
Kuriansky
Joseph
J
Amitai
Michal
M
Smolinsky
Aram Kurtz
AK
Hertz
Marjorie
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005260:Female; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D013158:Splenic Diseases / Q000000981:diagnostic imaging; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging; D013896:Thoracic Diseases / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed