Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- recent history of surgery, trauma, or intra-abdominal infection
- fever or hypothermia
- abdominal pain
- rectal tenderness and fullness
Otros factores de diagnóstico
- 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
Factores de riesgo
- recent surgery or trauma, appendicitis, diverticulitis, or perforated ulcer
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- WBC count
- drainage culture
- abdominal CT scan
Pruebas diagnósticas que deben considerarse
- serum CRP
- serum erythrocyte sedimentation rate (ESR)
- Gram stain of abscess fluid
- serum glucose
- abdominal ultrasound
- abdominal MRI scan
Pruebas emergentes
- endoscopic ultrasound
Algoritmo de tratamiento
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
Colaboradores
Autores
Laura Kreiner, MD, FACS
Assistant Professor of Surgery
MetroHealth Medical Center
Case Western Reserve University School of Medicine
Cleveland
OH
Divulgaciones
LK declares that she has no competing interests.
Agradecimientos
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.
Divulgaciones
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.
Revisores por pares
James T. Lee, MD, PhD, FACS, FIDSA, FSHEA
Professor of Surgery (retired)
University of Minnesota
Saint Paul
MN
Divulgaciones
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
Divulgaciones
JAC declares that he has no competing interests.
Matthew Falagas, MD, MSc, DSc
Director
Alfa Institute of Biomedical Sciences
Marousi
Athens
Greece
Divulgaciones
MF declares that he has no competing interests.
Diferenciales
- Loculated intra-abdominal hematoma
- Pancreatic pseudocyst
- Diverticular or appendiceal phlegmon
Más DiferencialesGuías de práctica clínica
- 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
Más Guías de práctica clínicaFolletos para el paciente
Appendicitis
Crohn disease: what is it?
Más Folletos para el pacienteInicie sesión o suscríbase para acceder a todo el BMJ Best Practice
El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad