title: Postoperative fluid collections after colon resection: the utility of clinical assessment.
abstract: BACKGROUND
  Computed tomography (CT) scans often identify postoperative fluid collections of uncertain clinical relevance.
  
  
  METHODS
  Consecutive 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.
  
  
  RESULTS
  Nine 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).
  
  
  CONCLUSIONS
  Clinical judgment is superior to radiologic and individual clinical parameters. This finding has the potential to prevent many unnecessary procedures.
authors.affiliation: Department of Surgery, University of Vermont College of Medicine, Burlington, VT 05401, USA.
authors.forename: Hagop
authors.initials: H
authors.lastname: Sarkissian
authors.forename: Neil
authors.initials: N
authors.lastname: Hyman
authors.forename: Turner
authors.initials: T
authors.lastname: Osler
mesh_terms: D018784:Abdominal Abscess / Q000175:diagnosis*; D003106:Colon / Q000601:surgery*; D003657:Decision Making; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007600:Judgment; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D012007:Rectum / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Abscess; CT scan; Colon resection; Fluid collection