Abdominal abscesses
Abdominal abscesses can develop in various locations such as beneath the diaphragm, within the central abdominal area, in the pelvic region, or at the back of the abdominal cavity. They can also occur in or around abdominal organs like the kidneys, spleen, pancreas, liver, or within the prostate gland. If left untreated, these abscesses can enlarge and harm adjacent blood vessels and organs.
- Many individuals experience ongoing stomach pain and fever.
- Imaging tests like CT scans help differentiate an abscess from other issues.
- The treatment includes draining the abscess and administering antibiotics.
In certain cases, bacteria from the abscess may enter the bloodstream, leading to sepsis, and disseminate to remote organs and tissues. This widespread infection can be life-threatening.
Causes of Abdominal Abscesses
Frequent causes of abdominal abscesses include the extension of infection or inflammation resulting from ailments like appendicitis, diverticulitis, Crohn’s disease, pancreatitis, or pelvic inflammatory disease.
At times, abdominal abscesses result from a perforation in the intestine caused by conditions such as cancer, ulcers, or trauma, and occasionally, abscesses develop following abdominal trauma or post-surgical procedures in the abdominal region.
Symptoms of Abdominal Abscesses
Abdominal abscesses often cause pain, malaise, fever, nausea, decreased appetite, and weight loss. A burst appendix can lead to an abscess under the diaphragm, causing cough, painful breathing, and shoulder pain. Middle abdomen abscesses, from issues like a burst intestine or inflammatory bowel disease, result in localized pain.
Lower abdominal abscesses might extend to the thigh or rectum area. Pelvic abscesses, similar to mid-abdominal ones or from gynecological infections, can lead to abdominal pain and urinary issues.
Retroperitoneal abscesses, behind the abdominal cavity, often stem from appendicitis or kidney infections, causing lower back pain. Pancreatic abscesses, post-acute pancreatitis, usually cause fever, abdominal pain, and vomiting.
Liver abscesses, from bacteria or amebas, lead to appetite loss, nausea, and fever. Spleen abscesses, from bloodstream infections or nearby abscess spread, cause pain in the left abdomen or shoulder.
Diagnosis of Abdominal Abscesses
Diagnosing an abscess can be challenging because its initial symptoms are often indistinct and mild, leading to potential misdiagnosis as they can resemble less severe, more common conditions.
When doctors suspect an abscess, they typically resort to imaging tests such as computed tomography (CT) scans of the abdomen and pelvis, or occasionally ultrasound (ultrasonography), abdominal and chest X-rays, or magnetic resonance imaging (MRI). These imaging techniques are crucial in differentiating an abscess from other medical issues and in determining the abscess’s origin, size, and exact location.
For a definitive diagnosis and treatment, doctors may perform needle aspiration, which involves inserting a needle through the skin to extract pus from the abscess and possibly placing a drain. To accurately position the needle, CT or ultrasound guidance is often used. The extracted fluid is then analyzed in a lab to identify the infecting organism, allowing for the selection of the most effective antibiotic treatment.
In some cases, radionuclide scanning is employed to help detect abscesses. This involves using a radionuclide to tag a substance that accumulates in a particular body area. The specific substance used varies depending on the body part being examined.
Treatment of Abdominal Abscesses
Doctors usually need to drain pus from nearly all abdominal abscesses, either through surgery or using a needle and catheter. They use CT or ultrasound scans to place the needle and catheter accurately. Once in the right spot, they remove the needle but leave the catheter to let the pus drain over days to weeks.
Along with drainage, doctors often prescribe antibiotics to stop the infection from spreading and to clear it completely. They analyze the pus in a lab to identify the infecting organism, which helps them choose the most effective antibiotic. Antibiotics alone rarely resolve an abscess without drainage.
If doctors can’t safely reach the abscess with a needle and catheter, they may need to perform surgical drainage. After draining the abscess, they also surgically treat its cause. For example, if a colon perforation caused the abscess, they often remove the affected colon segment.
Maintaining proper nutrition is essential during this time. If patients can’t eat due to the abscess or its cause, they might receive nutrition through a feeding tube or intravenously.
Prognosis for Abdominal Abscesses
Doctors usually need to drain pus from nearly all abdominal abscesses, either through surgery or using a needle and catheter. They use CT or ultrasound scans to place the needle and catheter accurately. Once in the right spot, they remove the needle but leave the catheter to let the pus drain over days to weeks.
Along with drainage, doctors often prescribe antibiotics to stop the infection from spreading and to clear it completely. They analyze the pus in a lab to identify the infecting organism, which helps them choose the most effective antibiotic. Antibiotics alone rarely resolve an abscess without drainage.
If doctors can’t safely reach the abscess with a needle and catheter, they may need to perform surgical drainage. After draining the abscess, they also surgically treat its cause. For example, if a colon perforation caused the abscess, they often remove the affected colon segment.
Maintaining proper nutrition is essential during this time. If patients can’t eat due to the abscess or its cause, they might receive nutrition through a feeding tube or intravenously.
