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Abdominal Visceral Abscess


Presentation

  • The pain is usually constant and is often present for several days prior to presentation. Patients may also have nausea and vomiting.[medical-institution.com]
  • Simple descriptive statistics and tables were used to present results.[sciencedomain.org]
  • […] is similarly variable, and patients may present with acute, subacute or chronic illness, each with different radiological findings.[radiopaedia.org]
  • Thus, presenting an unusual presentation of EPN as pneumoperitoneum and intra-abdominal wall abscess.[saudisurgj.org]
  • Appendicitis can be varied in how it presents but there are also many other diagnoses to consider when a patient presents with RIF pain. Assessment of abdominal pain in children can be very difficult.[patient.info]
Fever
  • Patients generally present with fever and abdominal pain.[medical-institution.com]
  • The fever persisted despite treatment with intravenous antibiotics (Ceftriaxone and Amikacin) for 48 hours.[indianpediatrics.net]
  • Aspects Fever and Abdominal Pain[antimicrobe.org]
  • Treatment Principle Herb Formulas Points Clinical Manifestations Itching or tickling in the throat Cough with expectoration of thin, watery or frothy white sputum Chills with low grade fever Anhidrosis No thirst Headache Aversion to Wind Blocked and [americandragon.com]
Weight Loss
  • Loss Part 7: Oncology and Hematology Part 8: Infectious Diseases Part 9: Terrorism and Clinical Medicine Part 10: Disorders of the Cardiovascular System Part 11: Disorders of the Respiratory System Part 12: Critical Care Medicine Part 13: Disorders of[accessmedicine.mhmedical.com]
  • Spiking fever, abdominal pain and tenderness (most often at the lower costal margin), and weight loss are common manifestations.[what-when-how.com]
  • . — Gastroparesis – can present with nausea, vomiting, abdominal pain, early satiety, postprandial fullness, bloating, and, in severe cases, weight loss. The most common causes are idiopathic, diabetic, or postsurgical.[medical-institution.com]
  • Carcinoma of the caecum or ascending colon : there is usually an associated change in bowel habit, weight loss and rectal bleeding.[patient.info]
  • Nausea, anorexia, and weight loss are common. Abscesses in the Douglas cul-de-sac, adjacent to the rectosigmoid junction, may cause diarrhea.[msdmanuals.com]
Malaise
  • Symptoms are malaise, fever, and abdominal pain. Diagnosis is by CT. Treatment is with drainage, either surgical or percutaneous. Antibiotics are ancillary.[msdmanuals.com]
  • Other symptoms may include weight loss, malaise and diarrhoea. On physical exam RUQ tenderness, guarding, rebound tenderness, hepatomegaly and occasional jaundice can be appreciated.[bjmp.org]
  • . — Hepatitis – Patients with acute hepatitis (eg, from hepatitis A, alcohol, or medications) may have fatigue, malaise, nausea, vomiting, and anorexia in addition to right upper quadrant pain.[medical-institution.com]
Fatigue
  • . — Hepatitis – Patients with acute hepatitis (eg, from hepatitis A, alcohol, or medications) may have fatigue, malaise, nausea, vomiting, and anorexia in addition to right upper quadrant pain.[medical-institution.com]
  • […] which is localized and hard Continuous cramping pain in the abdomen Pain is not severe Pain is relieved by pressure Edema of the feet Urinary difficulty Slight edema (primarily of the lower limbs) Symptoms generally occur during pregnancy Pale face Fatigue[americandragon.com]
  • Case Report Clinical history A 59-year-old woman presented with mild fatigue and mild upper left abdominal and left flank pain for more than five weeks.[omicsonline.org]
  • […] early satiety, postprandial fullness, anorexia, jaundice, choluria, acholia, pruritus, hematemesis, melena, enterorrhagia, arthritis, arthralgia, chest pain, urinary urgency, nighttime urination, dispareunia, dysmenorrhea, low back pain, dorsal pain, fatigue[scielo.br]
  • In time, however, the obstructed bowel fatigues and bowel motility decreases, resulting in hypoactive or absent bowel sounds as distention-inhibition and vascular impairment of the intestine develop.[research.ece.ncsu.edu]
Abdominal Pain
  • This article covers abdominal pain differential diagnosis.[medical-institution.com]
  • Be familiar with the differential diagnosis of abdominal pain based on symptoms and location of pain. Discuss the evaluation of acute abdominal pain. Distinguish surgical from medical abdominal pain.[pedsinreview.aappublications.org]
  • Keywords: Abdominal pain, Interdisciplinary treatment, Myofascial pain, Visceral pain.[scielo.br]
  • Aspects Fever and Abdominal Pain[antimicrobe.org]
  • Assessment of abdominal pain in children can be very difficult. Abdominal pain in pregnancy also causes problems because of distortion of the normal anatomy and stretching of structures by the gravid uterus.[patient.info]
Nausea
  • Normal pregnancy discomforts (eg, breast tenderness, frequent urination, nausea) are sometimes present.[medical-institution.com]
  • Listen for key features on history: sudden onset of unilateral pelvic pain, sometimes radiating to the groin, often associated with nausea and vomiting.[cdemcurriculum.com]
  • Patients typically present with severe abdominal pain and guarding, as well as nausea and vomiting. In most cases, peritonitis constitutes a surgical emergency.[amboss.com]
  • CASE REPORT: A 36-year-old African American male with a history of chronic pancreatitis presented to the emergency department for abdominal pain in the epigastric area along with nausea, vomiting, diarrhoea, fever.[bjmp.org]
  • TPs may trigger somatovisceral responses, including vomiting, anorexia, nausea, intestinal colic, diarrhea, vesical or sphincter spasm or dysmenorrhea.[scielo.br]
Abdominal Tenderness
  • Physical examination may reveal lower abdominal tenderness. On pelvic exam, the patient may have adnexal tenderness or an adnexal mass. Fever is uncommon, and usually low-grade if present.[cdemcurriculum.com]
  • Sudden severe pain, shock or shock-like state, marked abdominal tenderness and rigidity, localized or generalized, silent abdomen, severe systemic reaction. b.[research.ece.ncsu.edu]
  • Because abdominal pain, abdominal tenderness, or hepatomegaly is present in only half of cases, many of these patients present with fever of undetermined origin. Leukocytosis is present in most cases.[what-when-how.com]
  • Physical signs included abdominal tenderness 95.4% (166/174), cervical motion tenderness 32.2% (56/174), and adnexal tenderness 48.3% (84/174) ( Table 1 ). The mean WBC count was 16.1, and the mean neutrophil count was 13.4.[dovepress.com]
Chronic Abdominal Pain
  • Laparoscopy in chronic abdominal pain patients shows abnormalities in 53% of cases 13,14. It is worth stressing that peritoneal adhesions are in general not related to chronic abdominal pain.[scielo.br]
  • . — Irritable bowel syndrome (IBS) – Present with chronic abdominal pain and altered bowel habits. — Constipation – Constipation may be associated with abdominal pain.[medical-institution.com]
  • abdominal pain, ectopic pregnancy, and infertility. 7 It has been demonstrated that no single subjective complaint, physical examination finding, or laboratory test is highly sensitive or specific for the diagnosis of PID.[dovepress.com]
Left Lower Quadrant Pain
  • . — Diverticulitis – Left lower quadrant pain is the most common complaint. The pain is usually constant and is often present for several days prior to presentation. Patients may also have nausea and vomiting.[medical-institution.com]
  • This is promoted by the lodging of fecal material in a diverticulum with spread of inflammation to surrounding tissue, and is accompanied by left lower quadrant pain.[research.ece.ncsu.edu]
Tachycardia
  • Clinical Features  High spiking fevers  Chills  Tachycardia  Tachypnoea  Leukocytosis  Localised abdominal pain  Anorexia  Delay in return of bowel function 13.[slideshare.net]
  • […] valve 肺動脈弁欠損症/肺動脈弁欠損 abuse 虐待/乱用 academic general pediatrician アカデミック総合小児科医 acalculia 失計算 acanthocyte 有棘赤血球 acanthocytosis 有棘赤血球増加症 acanthosis nigricans 黒色表皮腫 acardiac fetus 無心胎児 acatalasemia 無カタラーゼ血/無カタラーゼ血症 acatalasia 無カタラーゼ症 accelerated junctional tachycardia[jpeds.or.jp]
  • Diagnosis of peritonitis includes classic abdominal symptoms (diffuse pain, guarding, rebound tenderness, rigidity, usually accompanied by “toxic” systemic signs (fever, tachycardia, tachypnea, leukocytosis or left shift SIRS).[cancertherapyadvisor.com]
  • A serum lactate and blood cultures are essential if the woman is systemically unwell (pyrexia, tachycardia, increased respiratory rate).[obgyn.onlinelibrary.wiley.com]
Hypotension
  • Sepsis definitions 24 Systemic inflammatory response syndrome (SIRS) a Severe sepsis Septic shock Temperature 38 C or SIRS lactic acidosis or hypotension Severe sepsis hypotension (despite adequate fluid resuscitation) Heart rate 90 bpm Respiratory rate[obgyn.onlinelibrary.wiley.com]
  • Patients with adrenal crisis may present with shock and hypotension. — Irritable bowel syndrome (IBS) – Present with chronic abdominal pain and altered bowel habits. — Constipation – Constipation may be associated with abdominal pain.[medical-institution.com]
  • However most patient will present with the classic triad of hypotension, a pulsating mass and back pain. Continuous leakage will lead to rupture into the peritoneal cavity and eventually death.[radiologyassistant.nl]
  • Norepinephrine can successfully increase blood pressure in patients who are septic and remain hypotensive following fluid resuscitation. Norepinephrine is effective to treat hypotension in septic shock patients.[wjes.biomedcentral.com]
  • Clinical features Clinical features of intra-abdominal infection include fever; tachycardia; tachypnea; hypotension; local, referred, generalized or absent abdominal pain; anorexia; nausea and vomiting; diarrhea; abdominal fullness; distension; obstipation[cancertherapyadvisor.com]
Arthritis
  • Chronic septic arthritis and osteomyelitis in a prosthetic knee joint due to Clostridium difficile. Eur J Clin Microbiol Infect Dis 14, 599 –601.[jmm.microbiologyresearch.org]
  • […] adynamia, syncope, adenomegalies, abdominal masses, nausea, vomiting, diarrhea, obstipation, abdominal distension, belching, pirosis, early satiety, postprandial fullness, anorexia, jaundice, choluria, acholia, pruritus, hematemesis, melena, enterorrhagia, arthritis[scielo.br]

Workup

  • (See Workup, Computed Tomography.) Sequential, multiple organ failure is the main cause of death.[emedicine.medscape.com]
  • Others are more often subacute in nature (viral hepatitis) and workup can proceed along at a less critical pace.[antimicrobe.org]
X-Ray Abnormal
  • Abscesses near the diaphragm may result in chest x-ray abnormalities such as ipsilateral pleural effusion, elevated or immobile hemidiaphragm, lower lobe infiltrates, and atelectasis. CBC and blood cultures should be done.[msdmanuals.com]
Elevated Sedimentation Rate
  • General signs of inflammation (such as elevated sedimentation rate, leucocytosis, and fever) may be absent. On urinalysis, bacteriuria and pyuria are absent in more than 80% of cases and urine culture is negative in most cases [ 14, 15 ].[jmedicalcasereports.biomedcentral.com]

Treatment

  • The treatment of intraabdominal abscesses includes drainage, surgical correction of pathology, and administration of antimicrobials effective against both aerobic and anaerobic microorganisms.[ncbi.nlm.nih.gov]
  • Traditional open surgical debridement was the treatment of choice for infection pancreatic necrosis but percutaneous CT guided drains (10-24Fr) are increasingly used and can be an effective means of treatment.[riamedical.com]
  • TREATMENT 47. 47 Treatment of Intra-abdominal Infections  Combination of modalities: A.[slideshare.net]
  • Treatment Principle Herb Formulas Points Clinical Manifestations Itching or tickling in the throat Cough with expectoration of thin, watery or frothy white sputum Chills with low grade fever Anhidrosis No thirst Headache Aversion to Wind Blocked and [americandragon.com]

Prognosis

  • This distinction is not only important for helping to predict prognosis, but is also vital for some treatment decisions.[nature.com]
  • Treatment and prognosis Treatment depends on the location of the infection and severity of systemic symptoms. Intravenous antibiotics are usually required and care must be taken as the organism is resistant to many antibiotics.[radiopaedia.org]
  • Association of an intra-abdominal abscess with remote organ failure, postoperative anastomotic leakage, non-localization of the abscess within the peritoneal cavity and gastrointestinal perforation due to typhoid enteritis was found to portend poor prognosis[biomedsearch.com]
  • A subphrenic abscess is usually secondary, with the primary disease process having a direct bearing on diagnosis, treatment and prognosis.[indianpediatrics.net]
  •  Untreated peritonitis is poor, usually resulting in death.  With Tx, prognosis is variable, dependent on the underlying causes. 37. 37 Peritonitis 38. 38 Peritonitis 39.[slideshare.net]

Etiology

  • The most common etiologies in adults being postoperative adhesions, malignancy related (eg, from colorectal cancer), and complicated hernias.[medical-institution.com]
  • Based on the etiology, peritonitis may be classified as primary or secondary. Primary peritonitis usually occurs in patients with underlying ascites, whereas secondary peritonitis affects those with a preexisting acute abdominal disease.[amboss.com]
  • Etiology Intra-abdominal abscesses are classified as intraperitoneal, retroperitoneal, or visceral (see table Intra-Abdominal Abscesses ). Many intra-abdominal abscesses develop after perforation of a hollow viscus or colonic cancer.[msdmanuals.com]
  • Complete Peer review History: Abstracts Aim: To determine the pattern of presentation, etiology, clinical features, and treatment outcome of intra-abdominal abscess in sub-urban Bayelsa Nigeria and suggest possible preventive measures.[sciencedomain.org]

Epidemiology

  • "Population-based study of the epidemiology of and the risk factors for pyogenic liver abscess". Clin Gastroenterol Hepatol. 2 (11): 1032–8. PMID 15551257 .[wikidoc.org]
  • Reference article This is a summary article ; read more in our article on bowel perforation. epidemiology depends on the cause presentation history may depend on the location of the perforation severe and generalised abdominal pain (upper) gradual and[radiopaedia.org]
  • Subphrenic abscess: the new epidemiology. Arch Surg, 1977; 112: 934–6.[ots1.narod.ru]
  • "National epidemiology of cutaneous abscesses: 1996 to 2005". The American Journal of Emergency Medicine. 27 (3): 289–92. doi : 10.1016/j.ajem.2008.02.027. PMID 19328372. a b c Elston, Dirk M. (2009). Infectious Diseases of the Skin.[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • Associated pathophysiologic effects may become life threatening or lead to extended periods of morbidity with prolonged hospitalization.[emedicine.medscape.com]
  • […] location of the perforation severe and generalised abdominal pain (upper) gradual and localised pain (lower) anorexia, nausea and vomiting examination rigid abdomen and generalised tenderness guarding and rebound bowel sounds range from quiet to absent pathophysiology[radiopaedia.org]
  • Pathophysiology 3 major defense mechanisms of peritoneal cavity Mechanical clearance via Diaphragmatic Lymphatics Phagocytosis and destruction of adherent bacteria Sequestration and walling off of bacteria, with delayed clearance 10.[slideshare.net]
  • To our knowledge this has never been reported in the literature and more work needs to be done to understand the pathophysiology of elevated pancreatic enzymes in the context of a liver abscess in a patient with a history of chronic pancreatitis.[bjmp.org]

Prevention

  • […] peritonitis that occurs when bacteria contaminate the peritoneum as a result of spillage from an intraabdominal viscus Prevention of secondary peritonitis: -prophylaxis for: 1. GRAM - AEROBIC BACILLI 2.[quizlet.com]
  • Suitability of the iliac crest as a site for harvest of autogenous bone grafts. 17257957 - Descending necrotizing mediastinitis treated with rapid sternotomy followed by vacuum-a... 23892537 - Pancreatic surgery. 23452747 - Novel oral anticoagulants for the prevention[biomedsearch.com]
  • Procedure The aim of the procedure is to drain the abscess, remove unhealthy tissues and ensure the cavity does not close to prevent abscess reformation. The wound is left open to heal (known as healing by secondary intention).[teachmesurgery.com]
  • Complete Peer review History: Abstracts Aim: To determine the pattern of presentation, etiology, clinical features, and treatment outcome of intra-abdominal abscess in sub-urban Bayelsa Nigeria and suggest possible preventive measures.[sciencedomain.org]
  • […] problem make arrangements to insert a central line to guide replacement Antibiotics are indicated - use local policies Continuing Management Laparotomy is usually indicated – inform theatre and anaesthetist Initial laparoscopy if experienced enough may prevent[jjs.me.uk]

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