Health Library

Intra-Abdominal Abscess

What is an intra-abdominal abscess?

An intra-abdominal abscess is a collection of pus or infected fluid that is surrounded by inflamed tissue inside the abdomen. It can involve any abdominal organ, or it can settle in the folds of the bowel.

What causes an intra-abdominal abscess?

Intra-abdominal abscesses sometimes happen because of another condition. An example might be appendicitis or diverticulitis. Many cases, however, happen after surgery. 

Abdominal abscesses can be caused by a bacterial infection. The most common bacteria to cause them are found in the stomach and intestines. One of these is E. coli. If left untreated, the bacteria will multiply and cause inflammation and kill healthy tissue.

What are the risk factors for an intra-abdominal abscess?

Abdominal surgery or trauma and conditions such as diabetes or inflammatory bowel disease can put you at risk for an intra-abdominal abscess.

What are the symptoms of an intra-abdominal abscess?

If you've recently had surgery or trauma to an abdominal organ and have other risk factors, such as diabetes or inflammatory bowel disease, be on the lookout for signs of an intra-abdominal abscess.

Common symptoms include:

  • Fever
  • Abdominal pain
  • Chest pain or shoulder pain 
  • Lack of appetite
  • Nausea and vomiting
  • Change in bowel movements
  • Rectal tenderness or fullness
  • Mass in the abdomen
  • Malnourishment

 

How is an intra-abdominal abscess diagnosed?

If you have symptoms of an intra-abdominal abscess, your health care provider may order tests to look for the presence of infection:

  • Blood tests. Blood may be drawn to look for signs of infection or an intra-abdominal abscess. Particularly useful are tests that look at the number of white blood cells and other indicators of inflammation.
  • Imaging tests. The best imaging test to check for an abscess is typically a CT scan to see inside the abdomen. Other techniques, such as ultrasound or MRI, may be used as well.
  • Physical exam. As part of your exam, your health care provider will take your temperature and check for tenderness in the abdomen. Sometimes, the abscess can be felt as a mass in the midsection.

How is an intra-abdominal abscess treated?

Antibiotics may help treat an infection that could lead to an intra-abdominal abscess. But once the abscess has developed, antibiotics don't work as well for treatment. An intra-abdominal abscess often will need to be drained of fluid in order to heal. Typically, however, antibiotics are given along with the drainage. The type of antibiotic will depend on how severe your abscess is, your age, and any other conditions you may have.

One way to remove fluid is through percutaneous drainage. This is a process in which your health care provider guides a needle through the skin to the place where the infection is. This is a short procedure. Your health care provider will give you a sedative and a local anesthetic to help you relax and eliminate any discomfort or pain while it is being done. 

Another way to drain the abscess is with surgery. Surgical procedures may also involve repairing the condition that caused the abscess in the first place, such as a bowel perforation. Sometimes, more than one operation is required.  

Your outcome will depend on the cause of your infection and how quickly you sought treatment. The right early treatment can significantly improve the outcome for people who develop intra-abdominal abscesses.  

While you are being treated for an intra-abdominal abscess, you may need nutritional support. This can be done by placing a feeding tube.

When should I call my health care provider?

If you've recently had surgery or trauma to an abdominal organ and have other risk factors, such as diabetes or inflammatory bowel disease, and you develop a fever, abdominal pain, nausea or vomiting, or other symptoms, you should immediately call your health care provider.

Key points

  • An intra-abdominal abscess is a collection of pus or infected fluid that is surrounded by inflamed tissue inside the abdomen
  • An intra-abdominal abscess may be caused by bacteria and, if left untreated, the bacteria will multiply and cause inflammation and kill healthy tissue
  • If you've recently had surgery or trauma to an abdominal organ and have other risk factors, such as diabetes or inflammatory bowel disease, be on the lookout for signs of an intra-abdominal abscess.
  • Early treatment can significantly improve the outcome for people who develop intra-abdominal abscesses

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.