Summary
Definition
History and exam
Key diagnostic factors
- recent history of surgery, trauma, or intra-abdominal infection
- fever or hypothermia
- abdominal pain
- rectal tenderness and fullness
Other diagnostic factors
- 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
Risk factors
- recent surgery or trauma, appendicitis, diverticulitis, or perforated ulcer
Diagnostic tests
1st tests to order
- WBC count
- drainage culture
- abdominal CT scan
- abdominal ultrasound
- abdominal MRI scan
Tests to consider
- serum CRP
- serum erythrocyte sedimentation rate (ESR)
- Gram stain of abscess fluid
- serum glucose
Emerging tests
- endoscopic ultrasound
Treatment algorithm
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
Contributors
Authors
Laura Kreiner, MD, FACS
Assistant Professor of Surgery
MetroHealth Medical Center
Case Western Reserve University School of Medicine
Cleveland
OH
Disclosures
LK declares that she has no competing interests.
Acknowledgements
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.
Disclosures
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.
Peer reviewers
James T. Lee, MD, PhD, FACS, FIDSA, FSHEA
Professor of Surgery (retired)
University of Minnesota
Saint Paul
MN
Раскрытие информации
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
Раскрытие информации
JAC declares that he has no competing interests.
Matthew Falagas, MD, MSc, DSc
Director
Alfa Institute of Biomedical Sciences
Marousi
Athens
Greece
Раскрытие информации
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.
Список литературы
Основные статьи
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.Полный текст Аннотация
Pieracci FM, Barie PS. Intra-abdominal infections. Curr Opin Crit Care. 2007 Aug;13(4):440-9. Аннотация
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.Полный текст Аннотация
American College of Radiology. ACR appropriateness criteria: radiologic management of infected fluid collections. 2019 [internet publication].Полный текст
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Отличия
- Loculated intra-abdominal hematoma
- Pancreatic pseudocyst
- Diverticular or appendiceal phlegmon
Больше ОтличияРекомендации
- 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
Больше РекомендацииЛифлеты для пациента
Appendicitis
Crohn disease: what is it?
Больше Лифлеты для пациентаВойдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice
Использование этого контента попадает под действие нашего заявления об отказе от ответственности