Abscesses and Other Intra-Abdominal Diseases

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.