Abscess - intra-abdominal

Definition

An intra-abdominal abscess is an infected pocket of fluid and pus located inside the belly area (abdominal cavity). There may be more than one abscess.

Alternative Names

Causes

An intra-abdominal abscess can be caused by a ruptured appendix, ruptured diverticula

Risk factors for intra-abdominal abscess include a history of appendicitis, diverticulitis, perforated ulcer disease, or any surgery that may have infected the abdominal cavity.

Symptoms

Depending on the location, symptoms may include:

• Fever
• Chills
• Abdominal pain and distention
• Weakness
• Lack of appetite
• Nausea
• Vomiting
• Rectal tenderness and fullness
• Diarrhea

Exams and Tests

The white blood cell count may be elevated on a complete blood count test. A CT scan of the abdomen will usually reveal an intra-abdominal abscess. In addition, after a CT scan, a needle may be placed through the skin into the abscess cavity to confirm diagnosis and treat the abscess. Liver function tests, abdominal x-ray, and sonogram may also be helpful in diagnosing abscess.

Sometimes laparotomy (opening of the abdomen, which is done under general anesthesia) may be necessary for diagnosis.

Treatment

Treatment of an intra-abdominal abscess requires antibiotics (given by an IV) and drainage. Drainage involves placing a needle through the skin in the abscess, usually under x-ray guidance. The drain is then left in place for days or weeks until the abscess goes away.

Occasionally, abscesses cannot be safely drained this way. In such cases, surgery must be done while the patient is under general anesthesia (unconscious and pain-free). A cut is made in the belly area (abdomen), and the abscess is drained and cleaned. A drain is left in the abscess cavity, and remains in place until the infection goes away.

It is always important to identify and treated the cause of the abscess.

Outlook (Prognosis)

The outlook depends on the original cause of the abscess and how bad the infection is. Generally, drainage is successful in treating intra-abdominal abscesses that have not spread.

Possible Complications

Complications include:

• Abscess returns (recurs)
• Rupture of an abscess
• Spread of the infection to the bloodstream
• Widespread infection

When to Contact a Medical Professional

Call your doctor if you have severe abdominal pain, fevers, nausea, vomiting, or changes in bowel habits.