Intra-Abdominal Abscesses

Abscesses may occur in the abdomen and retroperitoneum everywhere. In the majority of cases they occur following surgery, trauma, or diseases with abdominal infection and inflammation, v. a. if peritonitis or perforation occur. Symptoms include malaise, fever and abdominal pain. The diagnosis is made by CT. The treatment consists in a drainage, either surgical or percutaneous. Antibiotics are used concomitantly.

Abscesses may occur in the abdomen and retroperitoneum everywhere. In the majority of cases they occur following surgery, trauma, or diseases with abdominal infection and inflammation, v. a. if peritonitis or perforation occur. Symptoms include malaise, fever and abdominal pain. The diagnosis is made by CT. The treatment consists in a drainage, either surgical or percutaneous. Antibiotics are used concomitantly. In the intra-abdominal abscess etiology differentiates intraperitoneal, retroperitoneal or visceral (s. Intra-abdominal abscesses). Many intra-abdominal abscesses develop after perforation of a hollow organ or colon tumors. Others are caused by the spread of infection or inflammation from an appendicitis (appendicitis), diverticulitis (diverticulitis), Crohn’s disease (Crohn’s disease), pancreatitis (Overview of pancreatitis), inflammation of the small pelvis (pelvic inflammatory disease (PID)) or indeed, from any event that may cause a generalized peritonitis. The abdominal surgery, v. a. during operations on the gut or bile tract, represents a further significant risk factor: The peritoneum, during or after surgery, for example. B. be contaminated by Anastomosenlecks. As a result of abdominal trauma – v. a. Injuries and hematoma of the liver, pancreas, spleen and intestines – can abscesses occur, regardless of whether surgical repair is done or not. The causative pathogens represent the normal intestinal flora, or are a complex mixture of anaerobes and aerobes. Most common pathogens are aerobic gram-negative bacteria (eg., Escherichia coli and Klebsiella) and anaerobes (v. A., Bacteroides fragilis). Nichtdrainierte abscesses can spread into adjacent structures, neighboring vessels erode (bleeding and thrombosis verusachen), rupture in the peritoneum or the intestines or form a cutaneous or genitourinary fistula. Subdiaphragmatic abscesses can spread into the thoracic cavity, causing an empyema, a lung abscess or pneumonia. An abscess in the lower abdomen can hike in the thigh or in the perirectal fossa. Milzabszesse are a rare cause of bacteremia in a permanent endocarditis, which persists despite adequate antimicrobial therapy. Intra-abdominal abscesses localization Etiology The agent intraperitoneally subphrenic right or left lower quadrant between the intestinal loops parakolisch in the pelvis after surgery; Perforation of a hollow organ, appendicitis, diverticulitis or tumor; Crohn’s disease, pelvic inflammatory disease; generalized peritonitis etiology intestinal flora, frequently polymicrobial retroperitoneal pancreatic trauma, pancreatitis, intestinal flora, frequently polymicrobial perinephritisch propagation of a Nierenparenchymabszesses (complication of pyelonephritis or infrequent hematogenous from a remote Streuher) aerobic gram-negative bacteria visceral liver Trauma, ascending cholangitis, portal bacteremia aerobic gram-negative bacteria in biliary origin, polymicrobial flora in portal bacteremia, possibly amoeba infections (amebiasis) spleen injury, hematogenous, infarction. (Such as sickle cell disease and malaria) Staphylococci, Streptococci Anaerobic, aerobic Gram-negative bacteria including Salmonella, Candida in immunocompromised patients symptoms and complaints abscesses can form within a week of the perforations, or at a significant peritonitis, posto -operative abscesses however, do not occur 2-3 weeks ago after surgery, and in rare cases even after months. Basically, the findings in abscesses are variable, but most abscesses cause fever and abdominal pain (usually in the vicinity of the abscess) of very varying severity. A generalized or localized paralytic ileus may occur. often nausea, anorexia and weight loss. Abscesses in the Douglas area near the rectosigmoid connection can cause diarrhea. A break in the bladder can lead to urinary urgency and increased urination and if caused by diverticulitis, colonic bubbles form a fistula. Subphrenic abscesses make complaints in the area of ??the chest, eg. As non-productive cough, chest pain, dyspnea, and shoulder pain. Rales, wheezing and rubbing noise can be auscultated. A dullness to percussion and decreased breath sounds are typical in basal atelectasis, pneumonia and pleural effusions. Generally, the area above an abscess is sensitive and painful. Large abscesses may appear as palpable mass. Diagnostic abdominal CT rare radionuclide scanning case of suspected abscess, a CT of the abdomen and pelvis with contrast is the preferred diagnostic method. Other imaging examination methods may also provide information. Abdomenübersichtsaufnahmen show extraintestinal air in abscess, displacement of adjacent organs, soft tissue density, which represents the abscess, or a shaded psoas muscle. Abscesses near the diaphragm can cause the chest image, such pathologies. B. ipsilateral pleural effusion, elevated diaphragm or arrest, Unterlappeninfiltrate and atelectasis. A complete blood count and blood cultures are obtained. In most patients, leukocytosis occurs even anemia is common. Occasionally be helpful to identify intra-abdominal abscesses scintigraphy with 111Indium-labeled leukocytes. Pelvic abscess figure provided by Parswa Ansari, M.D. var model = {thumbnailUrl: ‘/-/media/manual/professional/images/pelvic_abscess_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/pelvic_abscess_high_de.jpg?la = en & thn = 0 ‘, title:’ pelvic abscess ‘description:’ u003Ca id = “v38395159 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eHier is shown in the basin as a result of appendicitis an abscess (red arrow). There are radiopaque faecal stones (white arrow) to see u003c / p u003e u003c / div u003e ‘credits’. Figure provided by Parswa Ansari

Health Life Media Team

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