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Intra-Abdominal Abscess

Localized purulent collection, CT-guided drainage, polymicrobial bacteria, source control

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Intra-Abdominal Abscess?

Intra-abdominal abscess forms when peritoneal contamination is contained by inflammatory walling, occurring after appendiceal, diverticular, or anastomotic perforation, postoperative leak, pancreatitis, hepatic or splenic infection, or pelvic inflammatory disease. Common locations include subphrenic, subhepatic, paracolic, pelvic, and interloop spaces.

Microbiology is polymicrobial in 80 percent of cases, with Escherichia coli, Klebsiella, Bacteroides fragilis, enterococci, and streptococci predominating. Atypical organisms include Candida in immunosuppressed and Mycobacterium tuberculosis in endemic areas or HIV patients.

Diagnosis combines clinical suspicion with computed tomography or magnetic resonance imaging showing fluid collection with rim enhancement and gas. Management is a percutaneous catheter drainage under image guidance plus empirical broad-spectrum antibiotics covering aerobic and anaerobic gram-negative bacteria. Surgical drainage is reserved for failed percutaneous approach, multiloculated collections, or ongoing source. Antibiotic duration depends on source control and clinical response.

Symptoms

Persistent fever and chills
Localized abdominal pain and tenderness
Anorexia, weight loss, malaise
Postoperative fever after seven days
Leukocytosis with left shift

Risk Factors

Recent abdominal surgery
Perforated appendicitis or diverticulitis
Crohn disease
Necrotizing pancreatitis
Immunosuppression

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • For persistent fever after surgery
  • For abdominal pain with leukocytosis
  • For failed antibiotic therapy
  • For palpable abdominal mass
  • For sepsis with no obvious source

Treatment Methods

01
CT or MRI to localize abscess
02
Percutaneous catheter drainage
03
Empirical broad-spectrum antibiotics
04
Culture-guided antibiotic adjustment
05
Surgical drainage if percutaneous fails
06
Source control of underlying cause

Which Department to Visit?

You can visit our Enfeksiyon Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Enfeksiyon Hastalıkları Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.