Abdominal Abscess

What is an abdominal abscess?

An abdominal abscess is when infected fluid (pus) builds up and forms a pocket (or abscess) in your abdomen (belly). The fluid can make you sick. You can develop sepsis if you don’t receive treatment, like antibiotics and a procedure to drain the abscess.

Abdominal abscesses happen for many reasons, most of which are out of your control. What you can do is get treatment as soon as you suspect there’s something going on in your belly. Treatment typically cures the condition. But without treatment, an abdominal abscess can be life-threatening.

Types of abdominal abscesses

Healthcare providers classify abdominal abscesses by the part of your belly that an abscess affects. Abdominal abscess types are:

• Intraperitoneal abscesses: This classification refers to abscesses that may develop below your diaphragm, your intestines, pelvis or stomach. You may also develop an abscess in the space between your diaphragm and liver (subphrenic abscess).
• Retroperitoneal abscesses: These are abscesses in your kidneys or pancreas.
• Visceral abscess: This classification refers to abscesses within a solid organ like your spleen or liver.

What are the symptoms of an abdominal abscess?

The specific symptoms are different depending on the abscess’s location. If you’re like most people, your symptoms may include:

• New, severe and constant pain that may be in your upper abdomen, lower back, shoulder or chest.
• Fever.
• Loss of appetite.
• Nausea.
• Unexplained weight loss.

What causes abdominal abscesses?

Like most abscesses, abdominal abscesses happen when you have a bacterial infection. When bacteria enter your body, your immune system sends white blood cells to get rid of the bacterial intruders.

This process causes inflammation that kills nearby tissue. When tissue dies, a pocket forms and fills with pus, creating an abscess. You may develop an abdominal abscess if you:

• Have a bacterial infection that starts in your belly.
• Have a condition — like Crohn’s disease, diverticulitis or pelvic inflammatory disease — that causes inflammation.
• Develop an infection after abdominal surgery.
• Have an injury, like a gunshot wound or stab wound, which lets bacteria into your belly.

Without treatment, an abdominal abscess can cause serious, life-threatening conditions like sepsis and organ failure.

How is an abdominal abscess diagnosed?

A healthcare provider will do a physical examination. They’ll ask about your symptoms. They’ll order a complete blood count (CBC) and the following imaging tests:

• Abdominal ultrasound.
• Chest X-ray.
• Computed tomography (CT) scan of your abdomen and pelvis. This is the most common test.
• Magnetic resonance imaging (MRI) scan.

They may do a fine needle aspiration to get a sample of pus from the abscess. A medical pathologist will do tests to identify the bacteria that are causing the infection.

How is an abdominal abscess treated?

The treatment for an abdominal abscess is a combination of antibiotics to fight the infection and a procedure to drain pus from the abscess. Your healthcare provider may recommend they do percutaneous abscess drainage (PAD).

PAD involves placing a drain or catheter into the abscess so that pus can flow into a connected bag. Your provider uses a CT scan or MRI scan to guide the catheter into place. You may receive local anesthesia before the procedure so that you’re awake during the procedure but you don’t feel pain. You may need to keep the catheter and bag in place for a few days after the procedure so the abscess can drain completely.

Treatment complications

Percutaneous abscess drainage (PAD) is a minimally invasive procedure. Like similar procedures, it may cause complications like:

• Bleeding.
• Pain.
• Surgical wound infection.

What can I expect if I have an abdominal abscess?

If you’re like most people, antibiotics to fight infection and treatment to drain pus from an abdominal abscess will eliminate the abscess. But abdominal abscesses happen because you have a condition that causes inflammation and infection. While treatment may clear up the bacterial infection, it won’t resolve the underlying condition.

When should I see my healthcare provider?

Contact your provider if you have symptoms like fever or persistent pain. These symptoms may mean you have another abdominal abscess.

A note from Cleveland Clinic

Abdominal abscesses develop when bacteria find a way into your belly. Once there, bacteria set the stage for an abscess. Without treatment, an abdominal abscess can become a life-threatening medical situation. Having a condition like Crohn’s disease or diverticulitis increases the chance you’ll have an abdominal abscess. If that’s your situation, ask a healthcare provider about symptoms that may mean there’s an abscess developing in your belly. That way, you’ll know when you should contact a provider.