Abdominal Abscesses

A bacterial infection frequently causes an abscess, which is a pus-filled pocket. Abdominal abscesses can happen beneath the diaphragm, in the region of the belly, in the pelvis, or somewhere behind the abdominal cavity. Abscesses can happen in any abdominal organ, such as the kidneys, spleen, pancreas, liver, and prostate gland. Abscesses that go untreated can expand and cause damage to neighboring blood vessels and organs. Bacteria can enter the bloodstream and spread to distant organs and tissues (sepsis). Such a spread has the potential to be fatal.

Abscesses in the abdomen can be caused by a variety of factors.

Perforation of the intestine due to malignancy, ulcer, or damage can result in abdominal abscesses.

The spread of infection or inflammation caused by illnesses including appendicitis, diverticulitis, Crohn’s disease, pancreatitis, or pelvic inflammatory disease is the most common cause.

Abscesses can arise after an injury to the abdomen or after abdominal surgery.

Symptoms

The symptoms of abdominal abscesses vary depending on where the abscess is located, however, most people have persistent discomfort or pain, feel ill (malaise), and frequently have a fever. Nausea, loss of appetite, and weight loss are some of the other symptoms.

When infected fluid, such as from a ruptured appendix, is forced upward by the pressure of abdominal organs and the suction caused when the diaphragm moves during breathing, an abscess can form below the diaphragm. Coughing, uncomfortable breathing, chest pain, and pain in one shoulder are all possible symptoms. The pain in one shoulder in this case is an example of transferred pain (pain felt in one area of the body that does not accurately represent where the problem is). Because the shoulder and the diaphragm share nerves referred pain occurs when the brain misinterprets the source of the pain.

A ruptured appendix, a ruptured intestine, inflammatory bowel disease, diverticular disease, and abdominal wound can develop abscesses in the mid-abdomen. In the area of the abscess, the abdomen is frequently uncomfortable.

A lower-abdominal abscess can spread to the thigh or the area around the rectum (called the perirectal fossa).

Pelvic abscesses can be caused by the same conditions that cause mid-abdominal abscesses, as well as gynecologic diseases. Abdominal pain, diarrhea from intestinal irritation, and an urgent or frequent need to urinate from bladder irritation are all possible symptoms.

Abscesses behind the peritoneum, the membrane that lines the abdominal cavity and organs, are known as retroperitoneal abscesses. Inflammation and infection of the appendix (appendicitis) and pancreas are among the causes, which are similar to those of abdominal abscesses (pancreatitis). When a person moves their leg at the hip, it causes pain in the lower back.

Pancreatic abscesses are uncommon, however, they commonly occur after an outbreak of acute pancreatitis. Fever, abdominal discomfort, nausea, and vomiting are major signs that appear a week or more after a person recovers from pancreatitis.

Bacteria or amebas can induce abscesses in the liver (single-celled parasites). An infected gallbladder, a piercing or blunt wound, an infection in the abdomen (such as a local abscess), or an infection transmitted by the bloodstream from elsewhere in the body can all cause bacteria to enter the liver. Through the blood arteries, amebas (microscopic parasites) from an intestine infection reach the liver. Loss of appetite, nausea and a fever are all signs of a liver abscess. Abdominal pain may not be present.

Abdominal Abscesses Diagnosis

Doctors can easily misdiagnose an abscess since the earliest symptoms are usually vague and moderate, and might be confused for less serious but more prevalent illnesses.

If doctors suspect an abscess, they may perform computed tomography (CT) of the belly and pelvis, ultrasound scanning (ultrasonography), x-rays of the abdomen and chest, or magnetic resonance imaging (MRI) of the abdomen and pelvis (MRI). These tests can assist identify an abscess from other issues and evaluate the abscess’s origins, size, and location

Doctors sometimes put a needle through the skin to extract a sample of pus from the abscess (needle aspiration) and place a drain to obtain a definitive diagnosis and treat the abscess. Doctors utilize CT or ultrasound scans to guide the needle placement. After that, a laboratory examines the fluid sample to identify the infecting organism so that the most effective antibiotic can be chosen.

Radionuclide scanning is sometimes used to assist diagnose abscesses. A radionuclide is a chemical that accumulates in a specific portion of the body and is used to mark it for scanning. Depending on the area of the body is being assessed, different chemicals are employed.

Abdominal Abscesses Prognosis

In roughly 10% to 40% of cases, abdominal abscesses result in mortality. The origin of the abscess and a person’s overall medical condition have a greater impact on the prognosis than the abscess’s specific type and location.

Abdominal Abscesses Treatment

Almost all abdominal abscesses require pus drainage, which can be done surgically or with a needle and a thin flexible tube (catheter). A doctor utilizes CT or ultrasound scans to guide the needle and catheter placement. The needle is removed but the catheter is left in place once the doctor is convinced the needle and catheter have reached the abscess. The pus drains out of the catheter over a period of days to weeks.

Antibiotics are frequently used in conjunction with drainage to prevent infection spread and to aid in the complete removal of the infection. The infecting bacterium is identified in the laboratory, allowing the most effective antibiotic to be chosen. Antibiotics are rarely used to treat abscesses that do not drain.

If the needle and catheter are unable to reach the abscess safely, surgical draining may be required. The cause of the infection is surgically treated after the abscess has been drained. If a perforation (hole) in the colon is the source of the abscess, surgeons will usually remove that section of the colon.

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