Abdominal Abscess

Overview

An abdominal abscess is a pocket of pus that forms inside your belly (abdomen). Pus is a thick fluid made of dead tissue, bacteria, and white blood cells. The body makes pus as it fights an infection. The abscess is the body's way of walling off the infection so it cannot spread. But if left untreated, it can cause serious illness.

Abdominal abscesses are not very common, but they do happen. They most often occur as a complication of surgery or an infection in the belly.

Anyone can get an abdominal abscess, but you are more likely to get one if you have had recent abdominal surgery, a digestive condition like diverticulitis or inflammatory bowel disease, or a weakened immune system.

Symptoms

Common symptoms

• Pain or tenderness in your belly
• Fever and chills
• Feeling bloated or swollen in the belly
• Nausea or vomiting
• Loss of appetite
• Feel very tired or generally unwell

Symptoms in children

• Fussiness or crying more than usual
• Poor feeding or not wanting to eat
• Swollen or painful belly
• Fever

Symptoms in older adults

• Confusion or being less alert than usual
• Loss of appetite and not drinking enough
• Less fever than you might expect
• Tiredness and weakness

Causes

Main causes

• A burst appendix or a ruptured diverticulum (a small pouch in the intestine that becomes infected)
• Infection that spreads from another organ, such as the gallbladder, liver, or pancreas
• Bacteria getting into the belly during or after abdominal surgery
• An injury that bruises or tears organs inside the belly

Risk factors

• Recent abdominal surgery
• Inflammatory bowel disease, such as Crohn's disease or ulcerative colitis
• A weakened immune system (for example, from illness or certain medicines)
• A history of abdominal infections or abscesses

When to see a doctor

See a doctor urgently if:

• If you have severe belly pain, very high fever, shaking chills, or you feel confused or faint, call your local emergency services right away.
• If you have pain that keeps getting worse over hours to days, or you cannot keep food or fluids down, seek urgent care today.

Book a routine appointment if:

• If you have had belly pain or a low-grade fever for more than a few days and you are not feeling better, make an appointment with your doctor.
• If you recently had abdominal surgery and have a persistent fever or new pain, tell your doctor.

Diagnosis

Your doctor will ask about your symptoms, examine your belly, and order one or more imaging scans to look for an abscess. They may also take blood tests to check for signs of infection.

Tests that may be done

• Blood tests to check your white blood cell count and other signs of infection
• CT scan (a special X-ray that creates detailed cross-section images of your belly)
• Ultrasound, which uses sound waves to create a picture of your organs and can spot fluid collections
• MRI, in certain cases, to get more detailed images

What to expect at your appointment

The scans are painless and usually take less than an hour. You may be asked to stop eating or drinking for a few hours before the CT scan or ultrasound. The results will help your doctor decide the best way to treat the abscess.

Treatment

Treatment for an abdominal abscess usually involves draining the pus and taking antibiotics to clear the infection. Your doctor will choose the approach based on the size, location, and cause of the abscess, as well as your overall health.

Self-care at home

• Take any antibiotics exactly as your doctor prescribes, even if you start to feel better.
• Rest and drink plenty of fluids to help your body recover.
• If you have a drain tube in place, keep the area around it clean and dry as you were shown.
• Follow your doctor's advice about when you can return to normal activities.

Medical treatments

You will usually be given antibiotics through a vein (intravenous or IV) in the hospital, and later by mouth. The main procedure is called percutaneous drainage: a doctor inserts a thin tube through your skin into the abscess, using imaging guidance, and drains the pus. You may keep the drain in place for a few days or longer.

When is surgery considered?

Surgery may be needed if the abscess cannot be drained safely with a needle or tube, if the drain does not work, or if the abscess is caused by a problem like a ruptured appendix or a blocked intestine that also needs to be repaired.

Living with this condition

After treatment, you will need time to recover. You may feel tired and have some pain or discomfort for a few weeks. Follow your doctor's instructions about wound care, medicines, and when you can resume normal routines.

Lifestyle tips

• Rest as much as you need, especially in the first week after treatment.
• Avoid heavy lifting or strenuous exercise until your doctor says it is safe.
• Attend all follow-up appointments so your doctor can make sure the infection is fully gone.

Diet and exercise

Eat light, balanced meals as your appetite returns. Start with food that is easy to digest if you have been unwell. Ask your doctor when it is safe to start or increase physical activity. Walking is often a good way to start.

Mental health and emotional wellbeing

Recovering from an abscess can be stressful, especially if you spent time in the hospital. You may feel anxious or low while you heal. It is normal to have these feelings. Talk to your doctor or your family about how you are doing.

Prevention

You cannot always prevent an abdominal abscess, but you can lower your risk. If you have surgery, your care team will use sterile techniques to reduce the chance of infection. If you have a condition like diverticulitis or inflammatory bowel disease, keeping it well managed may help prevent complications.

Vaccines

There is no vaccine specifically for abdominal abscess. But staying up to date on vaccines that protect against common infections may help your body fight off illness more easily.

Complications

If left untreated

• The infection can spread to the bloodstream, causing a life-threatening condition called sepsis.
• The abscess can grow and press on organs, blood vessels, or the airway.
• It can cause damage to surrounding tissues or organs.
• A sinus tract or fistula (an abnormal connection between organs) can form.

Long-term outlook

With early diagnosis and proper treatment, most people recover fully from an abdominal abscess. It can take time to regain your strength, but the outlook is very good when it is managed by a qualified healthcare team. Your doctor will guide you through each step of your recovery.

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