Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- febre ou hipotermia
- dor abdominal
- dor à palpação e sensação de preenchimento retal
Other diagnostic factors
- taquicardia
- alteração nos hábitos intestinais/função intestinal anormal
- íleo paralítico prolongado
- anorexia/falta de apetite
- náuseas e vômitos
- massa palpável
- sinais de sepse
- uso de corticosteroide pré-operatório
Risk factors
- cirurgia ou trauma recentes, apendicite, diverticulite ou úlcera perfurada
Diagnostic investigations
1st investigations to order
- contagem leucocitária
- cultura da drenagem
- tomografia computadorizada (TC) abdominal
- ultrassonografia abdominal
- ressonância nuclear magnética (RNM) abdominal
Investigations to consider
- proteína C-reativa sérica
- velocidade de hemossedimentação (VHS) sérica
- coloração de Gram do líquido do abscesso
- glicose sérica
Emerging tests
- ultrassonografia endoscópica
Treatment algorithm
abscesso intra-abdominal adquirido na comunidade: não considerado de alto risco, gravidade de leve a moderada
abscesso intra-abdominal adquirido na comunidade: risco elevado ou gravidade alta
abscesso intra-abdominal associado aos cuidados de saúde
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
Disclosures
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
Disclosures
JAC declares that he has no competing interests.
Matthew Falagas, MD, MSc, DSc
Director
Alfa Institute of Biomedical Sciences
Marousi
Athens
Greece
Disclosures
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.
References
Key articles
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.Full text Abstract
Pieracci FM, Barie PS. Intra-abdominal infections. Curr Opin Crit Care. 2007 Aug;13(4):440-9. Abstract
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.Full text Abstract
American College of Radiology. ACR appropriateness criteria: radiologic management of infected fluid collections. 2019 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Hematoma intra-abdominal loculado
- Pseudocisto pancreático
- Flegmão diverticular ou apendicular
More DifferentialsGuidelines
- ACR appropriateness criteria: radiologic management of infected fluid collections
- Revised guidelines on the management of intra-abdominal infection
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