121. Abscesses and Other Intra-Abdominal Diseases

  1. C. J. Hawkey FMedSci3,
  2. Jaime Bosch MD, PhD4,5,
  3. Joel E. Richter MD, FACP, MACG6,7,
  4. Guadalupe Garcia-Tsao MD8,9 and
  5. Francis K. L. Chan MD10
  1. Juliane Bingener MD1,
  2. Melanie L. Richards MD, MHPE1 and
  3. Kenneth R. Sirinek MD, PhD2

Published Online: 16 APR 2012

DOI: 10.1002/9781118321386.ch121

Textbook of Clinical Gastroenterology and Hepatology, Second Edition

Textbook of Clinical Gastroenterology and Hepatology, Second Edition

How to Cite

Bingener, J., Richards, M. L. and Sirinek, K. R. (2012) Abscesses and Other Intra-Abdominal Diseases, in Textbook of Clinical Gastroenterology and Hepatology, Second Edition (eds C. J. Hawkey, J. Bosch, J. E. Richter, G. Garcia-Tsao and F. K. L. Chan), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118321386.ch121

Editor Information

  1. 3

    Nottingham Digestive Diseases Centre, University of Nottingham and Nottingham University Hospitals, Nottingham, UK

  2. 4

    Hepatic Hemodynamic Laboratory, Liver Unit Hospital Clínic-IDIBAPS, University of Barcelona, Spain

  3. 5

    Biomedical Research Centre Network of Hepatic and Digestive Diseases (CIBERehd), National Institute of Health Carlos III Ministry of Science and Innovation Barcelona, Spain

  4. 6

    Division of Gastroenterology and Nutrition, University of South Florida Tampa, FL, USA

  5. 7

    Joy M. Culverhouse Center for Esophageal Diseases, University of South Florida Tampa, FL, USA

  6. 8

    Section of Digestive Diseases Yale University, School of Medicine New Haven, CT, USA

  7. 9

    Veterans Affairs Connecticut Healthcare System West Haven, CT, USA

  8. 10

    Department of Medicine & Therapeutics The Chinese University of Hong Kong, Hong Kong SAR, China

Author Information

  1. 1

    Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, MN, USA

  2. 2

    Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

Publication History

  1. Published Online: 16 APR 2012
  2. Published Print: 20 APR 2012

ISBN Information

Print ISBN: 9781405191821

Online ISBN: 9781118321386

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Keywords:

  • abscess;
  • diverticulitis;
  • appendicitis;
  • perforation;
  • postoperative infection;
  • surgical drainage;
  • image-guided drainage;
  • antibiotics;
  • liver abscess;
  • spleen abscess;
  • abscess with pancreatitis

Summary

Intra-abdominal abscess formation has two main venues: hollow viscous and solid organs. Luminal obstruction, inflammation, trauma, and anastomotic disruption can lead to hollow-organ perforation with abscess formation. Hematogenous infections, infection in continuity, and bacterial transgression are sources for solid-organ abscesses. Half of all serious intra-abdominal infections are found after surgery, but few laparotomies are followed by an intra-abdominal infection. Typical complaints are pain, tachycardia, and fever, but they may be non-specific, such as anorexia and weight loss. Severe infections can cause life-threatening fluid shifts and systemic inflammatory response syndrome. Laboratory and imaging studies are used to assess the source and severity of the infection. Cardiorespiratory support, antibiotic therapy, and source control (such as percutaneous or surgical drainage) are essential for successful treatment. Risk factors for increased mortality from intra-abdominal infections are older age, severe underlying disease, malnutrition, and inappropriate antimicrobial therapy.