gastrointestinal disorders
Intra Abdominal Abscesses
Treatment of Intra Abdominal Abscesses
IV antibiotics Drainage: Percutaneous or surgical Almost all intra-abdominal abscesses require drainage, either by percutaneous catheters or surgery. Exceptions to drainage include small (< 2 cm) pericolic or periappendiceal abscesses, or abscesses that are draining spontaneously to the skin or into the bowel. Drainage through catheters (placed with CT or ultrasound guidance) may be appropriate given the following conditions: Few abscess cavities are present. The drainage route does not traverse bowel or uncontaminated organs, pleura, or peritoneum. The source of contamination is controlled. The pus is thin enough to pass through the catheter. Antibiotics are not curative but may limit hematogenous spread and should be given before and after intervention. Therapy requires IV antibiotics active against bowel flora. Patients with community-acquired infection should be characterized as at low or high risk of treatment failure or death based on Symptoms and Signs , extremes of age, comorbidities, extent of abdominal infection, and risk of resistant bacteria. For community-acquired infection in patients at low risk, recommended regimens include Nutritional support is important, with the enteral route preferred. Parenteral nutrition should begin early if the enteral route is not feasible. 