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Intra-abdominal abscess

最后审阅: 14 Sep 2025
最后更新: 23 Apr 2025

小结

定义

病史和体格检查

关键诊断因素

  • recent history of surgery, trauma, or intra-abdominal infection
  • fever or hypothermia
  • abdominal pain
  • rectal tenderness and fullness
完整详情

其他诊断因素

  • tachycardia
  • change in bowel habits/abnormal bowel function
  • prolonged ileus
  • anorexia/lack of appetite
  • nausea and vomiting
  • palpable mass
  • signs of sepsis
  • preoperative corticosteroid use
完整详情

危险因素

  • recent surgery or trauma, appendicitis, diverticulitis, or perforated ulcer
完整详情

诊断性检查

首要检查

  • WBC count
  • drainage culture
  • abdominal CT scan
  • abdominal ultrasound
  • abdominal MRI scan
完整详情

需考虑的检查

  • serum CRP
  • serum erythrocyte sedimentation rate (ESR)
  • Gram stain of abscess fluid
  • serum glucose
完整详情

新兴检查

  • endoscopic ultrasound

治疗流程

急症处理

community-acquired intra-abdominal abscess: non-high risk, mild-to-moderate severity

community-acquired intra-abdominal abscess: high risk or high severity

health care-associated intra-abdominal abscess

撰稿人

作者

Laura Kreiner, MD, FACS

Assistant Professor of Surgery

MetroHealth Medical Center

Case Western Reserve University School of Medicine

Cleveland

OH

利益声明

LK declares that she has no competing interests.

鸣谢

Dr Laura Kreiner would like to gratefully acknowledge Dr Ali F. Mallat, Dr Lena M. Napolitano, and Dr Lillian Kao, previous contributors to this topic.

利益声明

AFM declares that he has no competing interests. LMN has been a member of the speakers' bureau and consultant for Merck, Pfizer, Schering-Plough, Ortho-McNeil, Wyeth, and Astellas Pharma. LK declares that she has no competing interests.

同行评议者

James T. Lee, MD, PhD, FACS, FIDSA, FSHEA

Professor of Surgery (retired)

University of Minnesota

Saint Paul

MN

利益声明

JTL declares that he has no competing interests.

Jeffrey A. Claridge, MD, MS, FACS

Director of Research

Division of Trauma, Burns and Critical Care

Assistant Professor

Department of Surgery

MetroHealth Medical Center

Case Western Reserve University School of Medicine

Cleveland

OH

利益声明

JAC declares that he has no competing interests.

Matthew Falagas, MD, MSc, DSc

Director

Alfa Institute of Biomedical Sciences

Marousi

Athens

Greece

利益声明

MF declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Mazuski JE, Tessier JM, May AK, et al. The Surgical Infection Society revised guidelines on the management of intra-abdominal infection. Surg Infect (Larchmt). 2017 Jan;18(1):1-76.全文  摘要

Pieracci FM, Barie PS. Intra-abdominal infections. Curr Opin Crit Care. 2007 Aug;13(4):440-9. 摘要

Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021 Nov;47(11):1181-247.全文  摘要

American College of Radiology. ACR appropriateness criteria: radiologic management of infected fluid collections. 2019 [internet publication].全文

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Intra-abdominal abscess images
  • 鉴别诊断

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    • Pancreatic pseudocyst
    • Diverticular or appendiceal phlegmon
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  • 指南

    • ACR appropriateness criteria: radiologic management of infected fluid collections
    • The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections
    更多 指南
  • 患者教育信息

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