The white blood cell count may be elevated on a complete blood count test. A CT scan of the abdomen will usually reveal an intra-abdominal abscess. In addition, after a CT scan, a needle may be placed through the skin into the abscess cavity to confirm diagnosis and treat the abscess. Liver function tests, abdominal x-ray, and sonogram may also be helpful in diagnosing abscess.
Sometimes laparotomy (opening of the abdomen, which is done under general anesthesia) may be necessary for diagnosis.
Causes
An intra-abdominal abscess can be caused by a ruptured appendix, ruptured diverticula, a parasite infection in the intestines (Entamoeba histolytica), or other condition.
Risk factors include a history of appendicitis, diverticulitis, perforated ulcer disease, or any surgery that may have infected the abdominal cavity.
Symptoms
Depending on the location, symptoms may include : -
Abdominal pain and distention
Chills
Diarrhea
Fever
Lack of appetite
Nausea
Rectal tenderness and fullness
Vomiting
Weakness
Signs and tests
The white blood cell count may be elevated on a complete blood count test. A CT scan of the abdomen will usually reveal an intra-abdominal abscess. In addition, after a CT scan, a needle may be placed through the skin into the abscess cavity to confirm diagnosis and treat the abscess. Liver function tests, abdominal x-ray, and sonogram may also be helpful in diagnosing abscess.
Sometimes laparotomy (opening of the abdomen, which is done under general anesthesia) may be necessary for diagnosis.
Before the operation
You may well be in hospital already, so some of the notes below are only for new comers. Stop smoking and get your weight down if you are overweight. (See Healthy Living)If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control.
Check the hospital's advice about taking the Pill or hormone replacement therapy (HRT). Check you have a relative or friend who can come with you to hospital, take you home, and look after you for the first week after the operation. Sort out any tablets, medicines, inhalers that you are using. Keep them in their original boxes and packets. Bring them to hospital with you.
On the ward, you will be checked for past illnesses and will have special tests to prepare you and make sure you can have the operation safely. Please tell the doctors and nurses of any allergies to tablets, medicines or dressings. You will have the operation explained to you and will be asked to fill in an operation consent form.
Before you sign the consent form, make sure that you fully understand all the information that was given to you regarding your health problems, the possible and proposed treatments and any potential risks. Feel free to ask more questions if things are not entirely clear. Many hospitals now run special preadmission clinics, where you visit a week or so before the operation, where these checks will be made.
Operational Procedure
You will have a general anaesthetic, and will be asleep for the whole operation. A cut about 3 inches long (8cm) is made in the skin of the tummy as near as possible to the abscess. The cut is deepened until the surgeon reaches the abscess. The pus then drains out to the skin. The surgeon also washes out the area of the abscess using a lot of fluid containing medicines, such as antibiotics to protect against any further problems with infection.
A rubber drainage tube is put down into the abscess space to drain out any further pus. This tube stays in place until it is clear from X-ray tests that the abscess space is getting smaller. The tube can then be shortened, bit by bit. Finally the wound dries up and heals over.
Prognosis
The outlook depends on the original cause of the abscess and how bad the infection is. Generally, drainage is successful in treating intra-abdominal abscesses that have not spread.
Possible Complications
Complications include : -
Return of the abscess
Rupture of an abscess
Spread of the infection to the bloodstream
Widespread infection
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