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 tests
1st tests to order
- contagem leucocitária
- cultura da drenagem
- tomografia computadorizada (TC) abdominal
Tests to consider
- proteína C-reativa sérica
- velocidade de hemossedimentação (VHS) sérica
- coloração de Gram do líquido do abscesso
- glicose sérica
- ultrassonografia abdominal
- ressonância nuclear magnética (RNM) abdominal
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.
Differentials
- Hematoma intra-abdominal loculado
- Pseudocisto pancreático
- Flegmão diverticular ou apendicular
More DifferentialsGuidelines
- 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
More GuidelinesPatient information
Apendicite
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