eMedicine Specialties > General Surgery > Abdomen

Abdominal Abscess: Follow-up

Author: Alan A Saber, MD, MS, FACS, Chief, Minimally Invasive Surgery and Bariatric Surgery, Associate Professor, Department of Surgery, Michigan State University
Coauthor(s): Raymond D LaRaja, MD, Chairman, Program Director, Clinical Professor, Department of Surgery, Cabrini Medical Center, Mount Sinai School of Medicine
Contributor Information and Disclosures

Updated: May 1, 2009

Outcome and Prognosis

The introduction of CT scanning for the diagnosis and drainage of intra-abdominal abscesses has led to a dramatic reduction in mortality rates. (See images below and Images 1-3.) Sequential, multiple system organ failure is the main cause of death. Incidence of death is correlated to the severity of the underlying cause, a delayed diagnosis, inadequate drainage, and unsuspected foci of infection in the peritoneal cavity or elsewhere. Risk factors for morbidity and mortality are multiple surgical procedures, age older than 50 years, multiple organ failure, and complex, recurrent, or persistent abscesses.1,11

Percutaneous computed tomography (CT) scan<FONT s...

Percutaneous computed tomography (CT) scan–guided drainage of postoperative subhepatic collection.

[ CLOSE WINDOW ]
Percutaneous computed tomography (CT) scan<FONT s...

Percutaneous computed tomography (CT) scan–guided drainage of postoperative subhepatic collection.



Contrast-enhanced computed tomography (CT) scan o...

Contrast-enhanced computed tomography (CT) scan of infected pancreatic pseudocyst (which can develop from acute necrotizing pancreatitis and give rise to an abscess).

[ CLOSE WINDOW ]
Contrast-enhanced computed tomography (CT) scan o...

Contrast-enhanced computed tomography (CT) scan of infected pancreatic pseudocyst (which can develop from acute necrotizing pancreatitis and give rise to an abscess).



A 35-year-old man with a history of Crohn disease...

A 35-year-old man with a history of Crohn disease presented with pain and swelling in the right abdomen. Figure A shows a thickened loop of terminal ileum adherent to the right anterior abdominal wall. In figure B, the right anterior abdominal wall, adjacent to the inflamed terminal ileum, is markedly thickened and edematous. Figure C shows a right lower quadrant abdominal wall abscess and enteric fistula (confirmed by the presence of enteral contrast in the abdominal wall).

[ CLOSE WINDOW ]
A 35-year-old man with a history of Crohn disease...

A 35-year-old man with a history of Crohn disease presented with pain and swelling in the right abdomen. Figure A shows a thickened loop of terminal ileum adherent to the right anterior abdominal wall. In figure B, the right anterior abdominal wall, adjacent to the inflamed terminal ileum, is markedly thickened and edematous. Figure C shows a right lower quadrant abdominal wall abscess and enteric fistula (confirmed by the presence of enteral contrast in the abdominal wall).


 


More on Abdominal Abscess

Overview: Abdominal Abscess
Workup: Abdominal Abscess
Treatment: Abdominal Abscess
Follow-up: Abdominal Abscess
Multimedia: Abdominal Abscess
References
[ CLOSE WINDOW ]

References

  1. Eberhardt JM, Kiran RP, Lavery IC. The impact of anastomotic leak and intra-abdominal abscess on cancer-related outcomes after resection for colorectal cancer: a case control study. Dis Colon Rectum. Mar 2009;52(3):380-6. [Medline].

  2. Yang YM, Tian XD, Zhuang Y, Wang WM, Wan YL, Huang YT. Risk factors of pancreatic leakage after pancreaticoduodenectomy. World J Gastroenterol. Apr 28 2005;11(16):2456-61. [Medline].

  3. Hasper D, Schefold JC, Baumgart DC. Management of severe abdominal infections. Recent Pat Antiinfect Drug Discov. Jan 2009;4(1):57-65. [Medline].

  4. Greenberg J, Arnell TD. Diverticular abscess presenting as an incarcerated inguinal hernia. Am Surg. Mar 2005;71(3):208-9. [Medline].

  5. Pedrazzoli S, Liessi G, Pasquali C, et al. Postoperative pancreatic fistulas: preventing severe complications and reducing reoperation and mortality rate. Ann Surg. Jan 2009;249(1):97-104. [Medline].

  6. [Best Evidence] van Randen A, Bipat S, Zwinderman AH, et al. Acute appendicitis: meta-analysis of diagnostic performance of CT and graded compression US related to prevalence of disease. Radiology. Oct 2008;249(1):97-106. [Medline].

  7. Hemming A, Davis NL, Robins RE. Surgical versus percutaneous drainage of intra-abdominal abscesses. Am J Surg. May 1991;161(5):593-5. [Medline].

  8. Rypens F, Dubois J, Garel L, et al. Percutaneous drainage of abdominal abscesses in pediatric Crohn's disease. AJR Am J Roentgenol. Feb 2007;188(2):579-85. [Medline]. [Full Text].

  9. Laborda A, De Gregorio MA, Miguelena JM, et al. Percutaneous treatment of intrabdominal abscess: urokinase versus saline serum in 100 cases using two surgical scoring systems in a randomized trial. Eur Radiol. Feb 4 2009;[Medline].

  10. Kimura T, Shibata M, Ohhara M. Effective laparoscopic drainage for intra-abdominal abscess not amenable to percutaneous approach: report of two cases. Dis Colon Rectum. Feb 2005;48(2):397-9. [Medline].

  11. Malangoni MA, Shumate CR, Thomas HA, Richardson JD. Factors influencing the treatment of intra-abdominal abscesses. Am J Surg. Jan 1990;159(1):167-71. [Medline].

  12. Aeder MI, Wellman JL, Haaga JR, Hau T. Role of surgical and percutaneous drainage in the treatment of abdominal abscesses. Arch Surg. Mar 1983;118(3):273-80. [Medline].

  13. Blankstein A, Cohen I, Diamant L, Heim M, Dudkiewicz I, Israeli A, et al. Achilles tendon pain and related pathologies: diagnosis by ultrasonography. Isr Med Assoc J. Aug 2001;3(8):575-8. [Medline].

  14. de Groot PC, Hjeltnes N, Heijboer AC, Stal W, Birkeland K. Effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured individuals. Spinal Cord. Dec 2003;41(12):673-9. [Medline].

  15. Dreyfuss P, Michaelsen M, Pauza K, McLarty J, Bogduk N. The value of medical history and physical examination in diagnosing sacroiliac joint pain. Spine. Nov 15 1996;21(22):2594-602. [Medline].

  16. Floemer F, Morrison WB, Bongartz G, Ledermann HP. MRI characteristics of olecranon bursitis. AJR Am J Roentgenol. Jul 2004;183(1):29-34. [Medline].

  17. Friedman ND, Sexton DJ. Bursitis due to Mycobacterium goodii, a recently described, rapidly growing mycobacterium. J Clin Microbiol. Jan 2001;39(1):404-5. [Medline].

  18. Fry DE, Garrison RN, Heitsch RC, Calhoun K, Polk HC Jr. Determinants of death in patients with intraabdominal abscess. Surgery. Oct 1980;88(4):517-23. [Medline].

  19. Gevargez A, Groenemeyer D, Schirp S, Braun M. CT-guided percutaneous radiofrequency denervation of the sacroiliac joint. Eur Radiol. Jun 2002;12(6):1360-5. [Medline].

  20. Grange CC, Bougenot MP, Groslambert A, Tordi N, Rouillon JD. Perceived exertion and rehabilitation with wheelchair ergometer: comparison between patients with spinal cord injury and healthy subjects. Spinal Cord. Oct 2002;40(10):513-8. [Medline].

  21. Hugate R, Pennypacker J, Saunders M, Juliano P. The effects of intratendinous and retrocalcaneal intrabursal injections of corticosteroid on the biomechanical properties of rabbit Achilles tendons. J Bone Joint Surg Am. Apr 2004;86-A(4):794-801. [Medline].

  22. Hungerford B, Gilleard W, Hodges P. Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine. Jul 15 2003;28(14):1593-600. [Medline].

  23. Kaiser AM, Jiang JK, Lake JP, Ault G, Artinyan A, Gonzalez-Ruiz C, et al. The management of complicated diverticulitis and the role of computed tomography. Am J Gastroenterol. Apr 2005;100(4):910-7. [Medline].

  24. Lorber B, Swenson RM. The bacteriology of intra-abdominal infections. Surg Clin North Am. Dec 1975;55(6):1349-54. [Medline].

  25. Lurie K, Plzak L, Deveney CW. Intra-abdominal abscess in the 1980s. Surg Clin North Am. Jun 1987;67(3):621-32. [Medline].

  26. Luukkainen RK, Wennerstrand PV, Kautiainen HH, Sanila MT, Asikainen EL. Efficacy of periarticular corticosteroid treatment of the sacroiliac joint in non-spondylarthropathic patients with chronic low back pain in the region of the sacroiliac joint. Clin Exp Rheumatol. Jan-Feb 2002;20(1):52-4. [Medline].

  27. Munson JL. Management of intra-abdominal sepsis. Surg Clin North Am. Dec 1991;71(6):1175-85. [Medline].

  28. Nichols RL. Infections following gastrointestinal surgery: intra-abdominal abscess. Surg Clin North Am. Feb 1980;60(1):197-212. [Medline].

  29. Prather H, Hunt D. Conservative management of low back pain, part I. Sacroiliac joint pain. Dis Mon. Dec 2004;50(12):670-83. [Medline].

  30. Raymond J, Davis GM, van der Plas M. Cardiovascular responses during submaximal electrical stimulation-induced leg cycling in individuals with paraplegia. Clin Physiol Funct Imaging. Mar 2002;22(2):92-8. [Medline].

  31. Saini S, Kellum JM, O'Leary MP, O'Donnell TF, Tally FP, Carter B, et al. Improved localization and survival in patients with intraabdominal abscesses. Am J Surg. Jan 1983;145(1):136-42. [Medline].

  32. Theisen D, Fornusek C, Raymond J, Davis GM. External power output changes during prolonged cycling with electrical stimulation. J Rehabil Med. Jul 2002;34(4):171-5. [Medline].

  33. Zwiren LD, Bar-Or O. Responses to exercise of paraplegics who differ in conditioning level. Med Sci Sports. 1975;7(2):94-8. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

abdominal abscess, abscess, fistula, pancreatitis, diverticulitis, appendicitis, abscesses, abscess treatment, ruptured appendix, drainage abscess, abscess surgery, abscess drain, abscess fistula, percutaneous drainage, colon abscess, surgical drainage, Escherichia coli, E coli, Bacteroides fragilis, B fragilis, intra-abdominal abscess, intra-abdominal suppuration

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Alan A Saber, MD, MS, FACS, Chief, Minimally Invasive Surgery and Bariatric Surgery, Associate Professor, Department of Surgery, Michigan State University
Alan A Saber, MD, MS, FACS is a member of the following medical societies: American College of Surgeons, American Society for Gastrointestinal Endoscopy, and American Society for Metabolic and Bariatric Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Raymond D LaRaja, MD, Chairman, Program Director, Clinical Professor, Department of Surgery, Cabrini Medical Center, Mount Sinai School of Medicine
Raymond D LaRaja, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, New York Academy of Medicine, and New York County Medical Society
Disclosure: Nothing to disclose.

Medical Editor

H Scott Bjerke, MD, FACS, Clinical Associate Professor, Department of Surgery, Indiana University School of Medicine, Medical Director of Trauma Services, Methodist Hospital, Clarian Health Partners, Inc
H Scott Bjerke, MD, FACS is a member of the following medical societies: American Association for the History of Medicine, American Association for the Surgery of Trauma, American College of Surgeons, Association for Academic Surgery, Eastern Association for the Surgery of Trauma, Midwest Surgical Association, National Association of EMS Physicians, Pan-Pacific Surgical Association, Royal Society of Medicine, Southwestern Surgical Congress, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Michael A Grosso, MD, Consulting Staff, Department of Cardiothoracic Surgery, St Francis Hospital
Michael A Grosso, MD is a member of the following medical societies: American College of Surgeons, Society of Thoracic Surgeons, and Society of University Surgeons
Disclosure: Nothing to disclose.

CME Editor

Paolo Zamboni, MD, Professor of Surgery, Chief of Day Surgery Unit, Chair of Vascular Diseases Center, University of Ferrara, Italy
Paolo Zamboni, MD is a member of the following medical societies: American Venous Forum and New York Academy of Sciences
Disclosure: Nothing to disclose.

Chief Editor

John Geibel, MD, DSc, MA, Vice Chairman, Professor, Department of Surgery, Section of Gastrointestinal Medicine and Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director of Surgical Research, Department of Surgery, Yale-New Haven Hospital
John Geibel, MD, DSc, MA is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, and Society for Surgery of the Alimentary Tract
Disclosure: AMGEN Royalty Other

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.