An intra-abdominal abscess is a collection of pus or infected fluid that is surrounded by inflamed tissue inside the abdomen. It can involve any abdominal organ, or it can settle in the folds of the bowel.
Intra-abdominal abscesses sometimes happen because of another condition. An example might be appendicitis or diverticulitis. Many cases, however, happen after surgery.
Abdominal abscesses can be caused by a bacterial infection. The most common bacteria to cause them are found in the stomach and intestines. One of these is E. coli. If left untreated, the bacteria will multiply and cause inflammation and kill healthy tissue.
If you've recently had surgery or trauma to an abdominal organ and have other risk factors, such as diabetes or inflammatory bowel disease, be on the lookout for signs of an intra-abdominal abscess.
Common symptoms include:
Lack of appetite
Nausea and vomiting
Change in bowel movements
Rectal tenderness or fullness
Mass in the abdomen
If you have symptoms of an intra-abdominal abscess, your doctor may order tests to look for the presence of infection:
Blood tests. Blood may be drawn to look for signs of infection or an intra-abdominal abscess. Particularly useful are tests that look at the number of white blood cells and other indicators of inflammation.
Imaging tests. The best imaging test to check for an abscess is typically a CT scan to see inside the abdomen. Other techniques, such as ultrasound or MRI, may be used as well.
Physical exam. As part of your exam, your doctor will take your temperature and check for tenderness in the abdomen. Sometimes, the abscess can be felt as a mass in the midsection.
Antibiotics may help treat an infection that could lead to an intra-abdominal abscess. But once the abscess has developed, antibiotics don't work as well for treatment. An intra-abdominal abscess often will need to be drained of fluid in order to heal. Typically, however, antibiotics are often given along with the drainage. The type of antibiotic will depend on how severe your abscess is, your age, and any other conditions you may have.
One way to remove fluid is through percutaneous drainage. This is a process in which your doctor guides a needle through the skin to the place where the infection is. This is a short procedure. Your doctor will give you a sedative and a local anesthetic to help you relax and eliminate any discomfort or pain while it is being done.
Another way to drain the abscess is with surgery. Surgical procedures may also involve repairing the condition that caused the abscess in the first place, such as a bowel perforation. Sometimes, more than one operation is required.
Your outcome will depend on the cause of your infection and how quickly you sought treatment. The right early treatment can significantly improve the outcome for people who develop intra-abdominal abscesses.