gastrointestinal disorders
Intra Abdominal Abscesses
Etiology of Intra Abdominal Abscesses
Intra-abdominal abscesses are classified as intraperitoneal, retroperitoneal, or visceral (see table). Many intra-abdominal abscesses develop after perforation of a hollow viscus or colonic cancer. Others develop by extension of infection or inflammation resulting from conditions such as Appendicitis , Abdominal surgery, particularly that involving the digestive or biliary tract, is a significant risk factor: The peritoneum may be contaminated during or after surgery by events such as anastomotic leaks. Traumatic abdominal injuries—particularly lacerations and hematomas of the liver, pancreas, spleen, and intestines—may develop abscesses, whether treated operatively or not. Theinfecting organismstypically reflect normal bowel flora and are a complex mixture of anaerobic and aerobic bacteria. Most frequent isolates are Aerobic gram-negative bacilli (eg, Escherichia coli Infections and Anaerobes (especially Mixed Anaerobic Infections ) Location Location Etiology Etiology Organisms Organisms Intraperitoneal Intraperitoneal Subphrenic Right or left lower quadrant Interloop Paracolic Pelvic Postoperative; perforation of hollow viscus, Appendicitis , Bowel flora, often polymicrobial Retroperitoneal Retroperitoneal Pancreatic Trauma, Overview of Pancreatitis None Bowel flora, often polymicrobial Perinephric Spread of renal parenchymal abscess (complication of pyelonephritis or rarely hematogenous from a remote source) Aerobic gram-negative bacilli Visceral Visceral Hepatic Trauma, ascending cholangitis, portal bacteremia Aerobic gram-negative bacilli if origin is biliary Polymicrobial bowel flora Amebiasis via the portal venous system Splenic Trauma, hematogenous, infarction (as in Sickle Cell Disease and Staphylococcal Infections , Candidiasis in patients with immunocompromise 