Intra-abdominal Abscesses: What Is It?

Intra-abdominal abscesses usually develop after an operation, an abdominal trauma or after illnesses associated with an infection or inflammation of the abdominal cavity.

Intra-Abdominal Abscesses: What Is It?

Intra-abdominal abscesses usually develop after an operation, an abdominal trauma or after diseases that are associated with an infection or inflammation of the abdominal cavity.

More precisely, these are purulent accumulations inside the abdominal cavity. They can appear anywhere there and are the result of inflammation, especially in the case of peritonitis or a perforation.

Causes of Intra-Abdominal Abscesses

Intra-abdominal abscesses

Some of the causes of intrabadomal abscesses are:

  • Infections caused by inflamed organs such as the gallbladder or appendix, as well as a perforation of the small or large intestine
  • serious abdominal trauma
  • Infections that occur in the postoperative phase, i.e. as a result of an operation

Intra-abdominal abscesses: symptoms

The most common symptoms include general malaise, fever, and abdominal pain. Occasionally, a palpation examination reveals accumulations in the abdominal area.

Intra-abdominal abscesses can develop within a week of perforation or peritonitis. However, the situation is different with those that are the result of an operation: These can only appear after two to three weeks and in rare cases after several months.

Although symptoms often vary, most abscesses are accompanied by a fever and abdominal pain. The symptoms can be mild or intense and can be accompanied by nausea, loss of appetite or weight loss.

Other intra-abdominal abscesses, such as the so-called Douglas space, can cause diarrhea. In addition, due to the proximity to the bladder, there is a risk of pollakiuria, i.e. urgent and frequent urination.

Subphrenic abscesses, on the other hand, can cause chest discomfort, such as an unproductive cough, chest pain and shortness of breath. As a rule, the area affected by the abscess hurts when palpating. Larger abscesses can feel like a mass.

Forms of intra-abdominal abscesses

Intra-abdominal abscesses can be divided into intraperitoneal, retroperitoneal, and visceral. Many of these abscesses develop after a hernia or colon cancer.

Other forms occur as a result of an extended infection or condition such as appendicitis, diverticulitis, pancreatitis, pelvic inflammation, Crohn’s disease, or a disorder that causes generalized peritonitis.

Another major risk factor is abdominal surgery, especially of the digestive system. The peritoneum can become contaminated during or after the procedure.

Undrained abscesses can cause damage to adjacent structures and vessels, which can lead to bleeding and thrombosis.

They can also penetrate into the intestines or the peritoneum and cause a skin or urogenital fistula there; an abdominal abscess can reach the thigh.

diagnosis

The diagnosis is made using an axial computed tomography. This technique allows one to find the best way to treat and drain the infection.

Magnetic resonance imaging is another imaging technique that is used in some situations. There are also simpler methods such as ultrasound. However, their image quality is not as good.

Intra-abdominal abscesses: treatment options

Treatment is given by antibiotics and percutaneous or surgical drainage. Almost all intra-abdominal abscesses require drainage, either using a percutaneous or surgical catheter.

Drainage via a catheter can be useful if the abscess cavities are large and do not pass through the contaminated organs such as the breast and peritoneum.

Drainage is also appropriate when the origin of the infection is controlled and the pus is fluid enough to circulate through the catheter.

Antibiotics can limit the spread of the infection through the blood and should be given both before and after the procedure. The treatment also requires active ingredients against the intestinal flora such as gentamicin and metronidazole.

In general, the treatment thus consists of draining the pus with the use of antibiotics. The drainage takes place through the skin and can be carried out using imaging methods such as ultrasound. In more severe cases, surgical drainage may be necessary.

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