Intra-abdominal Abscess Treatment

Risk Factors

Risk factors include:

• Recent abdominal or pelvic surgery
• Inflammatory bowel disease
• Diabetes mellitus
• Immunosuppression or steroid use
• Elderly age and poor nutrition
• Abdominal trauma

Who Is at Risk?

Patients who have undergone abdominal surgery, those with Crohn disease, diverticulitis, or perforated bowel are at highest risk. Diabetics and immunocompromised individuals also face significantly higher risk.

Diagnosis

Diagnosis involves:

• Blood tests including CBC and inflammatory markers (CRP, ESR)
• CT scan of the abdomen and pelvis with contrast
• Ultrasound-guided assessment
• MRI in complex or recurrent cases
• Diagnostic aspiration for culture and sensitivity

Treatment Options

Treatment depends on abscess size and severity. Small abscesses may respond to intravenous antibiotics alone. Most cases require image-guided percutaneous drainage. Complex or multiloculated abscesses may need laparoscopic or open surgical drainage for complete clearance.

Laparoscopic Abscess Drainage

Laparoscopic drainage is the minimally invasive approach for complex abscesses:

• General anaesthesia by specialist team
• Small keyhole incisions (5-12 mm) in the abdomen
• Laparoscope inserted for direct visualization
• Aspiration and drainage of the pus collection
• Saline washout of the cavity
• Surgical drain placement if needed
• Samples sent for culture and sensitivity
• Port site closure with absorbable sutures

This approach offers reduced pain, shorter hospital stay, and quicker recovery.

After the Surgery

Post-operative care includes:

• Monitoring of drain output and wound healing
• IV antibiotics tailored to culture results
• Gradual progression from liquids to solid diet
• Follow-up imaging to confirm abscess resolution
• Drain removal once output reduces
• Discharge within 3-5 days based on recovery

Possible Complications of Abscess Treatment

Possible complications include:

• Incomplete drainage and abscess recurrence
• Injury to surrounding organs or blood vessels
• Persistent infection or sepsis
• Fistula formation between abscess and adjacent bowel
• Bleeding from the drain site
• Anaesthesia-related risks
• Wound infection at port sites