The Accuracy of Early Post-Operative Abdominal CT Scan

Background: Data is lacking regarding the optimal CT timing for diagnosing intra-abdominal post-operative complications. Our aim was to examine the accuracy of CT imaging performed in the early post-operative period (POD 1-5) compared to late post-operative period (POD 6-14), in the detection of post-operative complications. Methods: Post-operative CT scans performed in the first 14 days following abdominal surgery, between 2011 and 2013 were reviewed and divided into two groups: early CT scans performed at POD 1-5 and late CT scans performed at POD 6-14. Analysis included clinical and laboratory parameters, radiologic findings and assessment of post-operative course according to CT scan results. Results: 318 CT scans were performed. The rate of repeated CT scans was higher in the patients included in the early CT scan group compared to the late CT scan group (23.1% vs. 11.2%, p=0.013). There were more re-operations in the early CT group, with no statistical difference (12.8% vs. 7.9%, p=0.23), whereas drainage procedures were more frequent in the late CT group (22.1% vs. 9.0%, p=0.008). Early CT scans were less sensitive in detecting post-operative GI complications (56% vs. 73%, p=0.018). The accuracy to detect post-operative complications was similar between the groups (83% vs. 88%, p=0.42). Conclusion: CT scans performed in the early post-operative period are less sensitive and tend to necessitate repeated scans. The accuracy of abdominal CT examination in detecting post-operative GI complications was not found to be statistically different between the early and late CT scan groups.