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Abscess - abdomen or pelvis
Abscess - intra-abdominal; Pelvic abscess
An abdominal abscess is a pocket of infected fluid and pus located inside the belly (abdominal cavity). This type of abscess can be located near or inside the liver, pancreas, kidneys or other organs. There can be one or more abscesses.
Causes
You can get abdominal abscesses because you have:
- A burst appendix
- A burst intestine
- A burst ovary
- Inflammatory bowel disease
- Infection in your gallbladder, pancreas, ovary or other organs
- Pelvic infection
- Parasite infection
You are more at risk for an abdominal abscess if you have:
- Trauma
- Perforated ulcer disease
- Surgery in your belly area
- Weakened immune system
Germs may pass through your blood to an organ in your belly. Sometimes, no reason can be found for an abscess.
Symptoms
Pain or discomfort in the belly that does not go away is a common symptom. This pain:
- May be found only in one area of your belly or over most of your belly
- May be sharp or dull
- May become worse over time
Depending on where the abscess is located, you may have:
- Pain in your back
- Pain in your chest or shoulder
Other symptoms of an abdominal abscess may be a lot like symptoms of having the flu. You may have:
- Swollen belly
- Diarrhea
- Fever or chills
- Lack of appetite and possible weight loss
- Nausea or vomiting
- Weakness
- Cough
Exams and Tests
Your symptoms can be a sign of many different problems. Your health care provider will do some tests to help determine if you have an abdominal abscess. These may include the following tests:
-
Complete blood count
-- A high white blood cell count is a possible sign of an abscess of other infection.
Complete blood count
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
ImageRead Article Now Book Mark Article - Comprehensive metabolic panel -- This will show any liver, kidney or blood problems.
Other tests that should show abdominal abscesses:
- Abdominal x-ray
- Ultrasound of the abdomen and pelvis
-
CT scan
of the abdomen and pelvis
CT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
ImageRead Article Now Book Mark Article -
MRI
of the abdomen and pelvis
MRI
An abdominal magnetic resonance imaging scan is an imaging test that uses powerful magnets and radio waves. The waves create pictures of the inside ...
ImageRead Article Now Book Mark Article
Treatment
Your health care team will try to identify and treat the cause of the abscess. Your abscess will be treated with antibiotics and drainage of the pus. At first, you will likely receive care in the hospital.
ANTIBIOTICS
You will be given antibiotics to treat the abscess. You will take them for up to 4 to 6 weeks.
- You will start on IV antibiotics in the hospital and you may receive IV antibiotics at home.
- You then may change to pills. Be sure you take all of your antibiotics, even if you feel better.
DRAINAGE
Your abscess needs to be drained of pus. Your provider and you will decide the best way to do this.
Using a needle and drain -- Your provider puts a needle through the skin and into the abscess. Usually, this is done with the help of x-rays to make sure the needle is inserted into the abscess.
Your provider will give you medicine to make you sleepy, and medicine to numb the skin before the needle is inserted into the skin.
A sample of the abscess will be sent to the lab. This helps your provider choose which antibiotics to use.
A drain is left in the abscess so that pus can drain out. Usually, the drain is kept in for days or weeks until the abscess gets better.
Having surgery -- Sometimes, a surgeon does surgery to clean out the abscess. You will be put under general anesthesia so that you are asleep for the surgery . Surgery may be needed if:
General anesthesia
General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...
Surgery
Abdominal exploration is surgery to look at the organs and structures in your belly area (abdomen). This includes your:AppendixBladderGallbladderIn...
- Your abscess cannot be reached safely using a needle through the skin
- Your appendix, intestines, or another organ has burst
The surgeon will make a cut into the belly area. Laparotomy involves a larger cut. Laparoscopy uses a very small cut and a laparoscope (a tiny video camera). The surgeon will then:
Laparotomy
Abdominal exploration is surgery to look at the organs and structures in your belly area (abdomen). This includes your:AppendixBladderGallbladderIn...
Laparoscopy
Diagnostic laparoscopy is a procedure that allows a doctor to look directly at the contents of the abdomen or pelvis.
- Clean and drain the abscess.
- Put a drain into the abscess. The drain stays in until the abscess gets better.
Outlook (Prognosis)
How well you respond to treatment depends on the cause of the abscess and how bad the infection is. It also depends on your overall health. Usually, antibiotics and drainage takes care of abdominal abscesses that have not spread.
You may need more than one operation. Sometimes, an abscess will come back.
Possible Complications
Complications may include:
- The abscess may not drain fully.
- The abscess may come back (recur).
- The abscess may cause severe illness and a bloodstream infection.
- The infection could spread.
When to Contact a Medical Professional
Call your provider if you have:
- Severe abdominal pain
- Fevers
- Nausea
- Vomiting
- Changes in bowel habits
References
De Prisco G, Celinski S, Spak CW. Abdominal abscesses and gastrointestinal fistulas. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 28.
Shapiro NI, Zimmer GD, Barkin AZ. Sepsis syndromes. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 138.
Squires R, Carter SN, Postier RG. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 20th ed. Philadelphia, PA: Elsevier; 2017:chap 45.
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Intra-abdominal abscess, CT scan - illustration
CT scan of the pelvis showing a large intra-abdominal mass.
Intra-abdominal abscess, CT scan
illustration
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Meckel diverticulum - illustration
Meckel diverticulum is one of the most common congenital abnormalities. It occurs when the connection between the intestine and the umbilical cord doesn't completely close off during fetal development. This results in a small outpouching of the small intestine, know as a Meckel diverticulum. In most cases, Meckel diverticula do not cause any problems. In a small number of patients however, these diverticula can become infected (diverticulitis) cause an obstruction of the instesitne, or cause bleeding from the intestine. The most common symptom of Meckel diverticulitis is painless bleeding from the rectum. The stools may contain fresh blood or may look black and tarry.
Meckel diverticulum
illustration
-
Intra-abdominal abscess, CT scan - illustration
CT scan of the pelvis showing a large intra-abdominal mass.
Intra-abdominal abscess, CT scan
illustration
-
Meckel diverticulum - illustration
Meckel diverticulum is one of the most common congenital abnormalities. It occurs when the connection between the intestine and the umbilical cord doesn't completely close off during fetal development. This results in a small outpouching of the small intestine, know as a Meckel diverticulum. In most cases, Meckel diverticula do not cause any problems. In a small number of patients however, these diverticula can become infected (diverticulitis) cause an obstruction of the instesitne, or cause bleeding from the intestine. The most common symptom of Meckel diverticulitis is painless bleeding from the rectum. The stools may contain fresh blood or may look black and tarry.
Meckel diverticulum
illustration
Review Date: 8/2/2016
Reviewed By: Raymond S. Koff, MD, Clinical Professor of Medicine, University of Connecticut School of Medicine, Farmington, CT. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
