Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- recent history of surgery, trauma, or intra-abdominal infection
- fever or hypothermia
- abdominal pain
- rectal tenderness and fullness
Outros fatores diagnósticos
- 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
Fatores de risco
- recent surgery or trauma, appendicitis, diverticulitis, or perforated ulcer
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- WBC count
- drainage culture
- abdominal CT scan
- abdominal ultrasound
- abdominal MRI scan
Investigações a serem consideradas
- serum CRP
- serum erythrocyte sedimentation rate (ESR)
- Gram stain of abscess fluid
- serum glucose
Novos exames
- endoscopic ultrasound
Algoritmo de tratamento
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
Declarações
LK declares that she has no competing interests.
Agradecimentos
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.
Declarações
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
James T. Lee, MD, PhD, FACS, FIDSA, FSHEA
Professor of Surgery (retired)
University of Minnesota
Saint Paul
MN
Declarações
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
Declarações
JAC declares that he has no competing interests.
Matthew Falagas, MD, MSc, DSc
Director
Alfa Institute of Biomedical Sciences
Marousi
Athens
Greece
Declarações
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.
Referências
Principais artigos
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.Texto completo Resumo
Pieracci FM, Barie PS. Intra-abdominal infections. Curr Opin Crit Care. 2007 Aug;13(4):440-9. Resumo
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.Texto completo Resumo
American College of Radiology. ACR appropriateness criteria: radiologic management of infected fluid collections. 2019 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Loculated intra-abdominal hematoma
- Pancreatic pseudocyst
- Diverticular or appendiceal phlegmon
Mais Diagnósticos diferenciaisDiretrizes
- 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
Mais DiretrizesFolhetos informativos para os pacientes
Appendicitis
Crohn disease: what is it?
Mais Folhetos informativos para os pacientesConectar-se ou assinar para acessar todo o BMJ Best Practice
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