An abscess is accumulation of pus surrounded by inflamed tissue that serves as a pocket. Abscess can develop anywhere in the body. A pocket of pus formed in the abdominal cavity is called intra-abdominal abscess. Abscess in the abdomen can develop either under the diaphragm, in the center of the abdomen or on the posterior side of abdomen or in the pelvic area. It can also form in any of the abdominal organs such as liver, appendix, pancreas, kidney etc.
Abdominal abscess occurs due to many reasons. It can be caused due to perforation of the intestine from an injury, cancer, ulcer etc.Bacterial infection and inflammation present in conditions like appendicitis, cholecystitis, pancreatitis etc can also lead to abdominal abscess.
Severe abdominal pain, fever, lack of appetite, loss of weight, malaise etc are some of the symptoms of abdominal abscess. Intra-abdominal abscess needs urgent medical attention. If left untreated it can lead to life threatening condition called sepsis.
What Causes Intra-Abdominal Abscess?
There are wide varieties of reasons linked in formation of intra abdominal abscess. It usually develops in a patient having preexisting medical disease of the abdominal organ. It can also occur after an abdominal surgery or due to an infection in the abdominal cavity (peritoneum).Majority cases of abdominal abscess are caused because of bacterial infection. Bacteria are usually found in stomach and intestine. E. coli is considered to be the main culprit in development of abdominal abscess.
The Risk of abdominal abscess increases if there is perforation of stomach and intestine or in conditions such as appendicitis, pancreatitis, cholecystitis etc. An injury to the abdomen can lead to intra abdominal abscess. An abscess in the abdomen can also develop after an abdominal surgery. Although majority of abdominal abscess are caused due to bacterial infection, fungi can also be a causative agent in patients who are on antibiotic therapy for long duration. Amoebic liver abscess is caused due to protozoa called amoeba.
Symptoms Of Intra-Abdominal Abscess
The specific symptoms depend on the location of abscess and the organ involved. However, the general symptoms are present in all cases of abdominal abscess. These symptoms include moderate to severe abdominal pain, tenderness in abdomen, fever, chills, nausea, lack of appetite and loss of weight.
Some of the symptoms are specific to the organ involved. For example an abscess under the diaphragm will cause cough, pain in chest while breathing, pain in the shoulder of the affected side. It is referred pain as the nerve innervating the shoulder and the diaphragm is same. Change in bowel movement can occur due to an abscess in the lower gastrointestinal tract or the pelvis.
Diagnosis and Treatment For Intra Abdominal Abscess
If intra abdominal abscess is suspected, the health care provider will recommend certain tests after physical examination and taking medical history. Blood tests such as complete blood count, erythrocyte sedimentation rate are primary blood tests that may help to know presence of infection. In case of abscess there is abnormal rise in white cell count and ESR value. CT scan of abdomen and sonogram of abdomen and pelvis is most confirmative test to diagnose an abscess in the abdomen. Sometimes an abscess mass can be felt during physical examination.
Intra abdominal abscess needs medical treatment. If left untreated the infection can infiltrate the blood stream leading to sepsis a life threatening condition. Drainage of pus and antibiotic are two mainstay treatment of abdominal abscess. Pus has to be drained either with a needle or open abdominal surgery.
For a small abscess that can be reached by the needle, pus is extracted out by inserting the needle in the abscess. Pus will drain from the catheter that is attached to the needle. Sonogram or CT scan is used to guide the needle and catheter to reach the abscess accurately.
In case of deep seated abdominal abscess or a large abscess surgical drainage may be a choice of treatment. Once the pus is drained, the source of infection is also treated. Antibiotics are administered simultaneously to prevent spread of infection and eliminate the organism.