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Intra-abdominal abscess

Última revisão: 14 Aug 2025
Última atualização: 23 Apr 2025

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
Detalhes completos

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
Detalhes completos

Fatores de risco

  • recent surgery or trauma, appendicitis, diverticulitis, or perforated ulcer
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • WBC count
  • drainage culture
  • abdominal CT scan
  • abdominal ultrasound
  • abdominal MRI scan
Detalhes completos

Investigações a serem consideradas

  • serum CRP
  • serum erythrocyte sedimentation rate (ESR)
  • Gram stain of abscess fluid
  • serum glucose
Detalhes completos

Novos exames

  • endoscopic ultrasound

Algoritmo de tratamento

AGUDA

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

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

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.
  • Intra-abdominal abscess images
  • Diagnósticos diferenciais

    • Loculated intra-abdominal hematoma
    • Pancreatic pseudocyst
    • Diverticular or appendiceal phlegmon
    Mais Diagnósticos diferenciais
  • Diretrizes

    • 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 Diretrizes
  • Folhetos informativos para os pacientes

    Appendicitis

    Crohn disease: what is it?

    Mais Folhetos informativos para os pacientes
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