Edit concept Question Editor Create issue ticket

Intraperitoneal Abscess in the Right Lower Quadrant

Intraperitoneal Abscess Right Lower Quadrant


Presentation

  • […] problems in critical care includes practical infection control measures provides easy to use recommendations on empiric antibiotic therapy furnishes a simple, effective method of adjusting drug doses in patients with abnormal hepatic and kidney function presents[books.google.com]
  • While most cases of intestinal malrotation present with bilious vomiting in the first month of life[ 1 ], rare cases present in adulthood[ 2 ].[wjgnet.com]
  • A high fever is present in the initial stages but in severe peritonitis there may be hypothermia. Tachycardia is usually present. The classic abdominal signs are tenderness on palpation, guarding and rebound tenderness.[patient.info]
  • Enter the name for this tabbed section: Case Case: A 23yo female presents with acute onset severe lower abdominal pain that woke her from sleep 5 hours prior to presentation. Pain is constant. No nausea or vomiting. No fevers. LMP 2-3 months prior.[emergencyultrasoundteaching.com]
  • 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]
Fever
  • Guidelines for the use of antimicrobial agents in neutropenic patients with unexplained fever. J Infect Dis 1990; 161:381—396. ‏ معلومات المراجع[books.google.com]
  • Supplementary points : Fever : Dazhui ( Du 14 ), Hegu ( Li4 ). Vomiting : Neiguan ( P 6 ), Zhongwan ( Ren 12 ). Explanation : Lanwei ( Extra ) is an empirical point in treating the intestinal abscess.[geocities.ws]
  • Aspects Fever and Abdominal Pain[antimicrobe.org]
  • Fever and chills and left upper quadrant pain are common.[what-when-how.com]
Chills
  • Soon the pain becomes continuous and localized in the right lower abdomen near Tianshu ( S 25 ), accompanied by tenderness, mild contracture of the abdominal wall, difficulty in extension of the right leg, fever, chills, nausea, vomiting, constipation[geocities.ws]
  • Fever and chills and left upper quadrant pain are common.[what-when-how.com]
  • You may have: Swollen belly Diarrhea Fever or chills Lack of appetite and possible weight loss Nausea or vomiting Weakness Cough Your symptoms can be a sign of many different problems.[medlineplus.gov]
  • These may be later followed by shock, toxemia, restlessness and irritability, a higher temperature, an increase in the pulse rate, and chills and convulsions.[anaerobicinfections.blogspot.com]
Rigor
  • Intermittent bacteremia can result in recurrent fevers and rigors. Liver seeding can occur through the hepatic portal veins.[sharinginhealth.ca]
  • If it is consistently less, it is likely that some unnecessary operations are being performed, and a more rigorous preoperative differential diagnosis is in order.[intranet.tdmu.edu.ua]
  • In addition to cutaneous lesions, patients can experience fevers, sweats, rigors, right upper quadrant pain, or pain from bony lytic lesions.[hivinsite.ucsf.edu]
Malaise
  • Symptoms are malaise, fever, and abdominal pain. Diagnosis is by CT. Treatment is with drainage, either surgical or percutaneous. Antibiotics are ancillary.[merckmanuals.com]
  • CT of abdominal abscess Liver abscesses generally presents with fever accompanied by chills, malaise, sweats and aching pain and tenderness over the liver or epigastrium.[anaerobicinfections.blogspot.com]
  • Symptoms Most symptoms are nonspecific and may include: easy bruising fatigue malaise weight loss Other symptoms or diseases may occur as a result of the primary disorder that caused the cirrhosis.[my.ilstu.edu]
Abdominal Pain
  • Aspects Fever and Abdominal Pain[antimicrobe.org]
  • pain, unspecified R1011Right upper quadrant pain R1012Left upper quadrant pain R1013Epigastric pain R102Pelvic and perineal pain R1030Lower abdominal pain, unspecified R1031Right lower quadrant pain R1032Left lower quadrant pain R1033Periumbilical pain[cms.gov]
  • Abdominal pain in general is perhaps one of the most difficult symptoms to evaluate.[clinicaladvisor.com]
  • With acute upper abdominal pain, CXR and EKG Management Although the management of abdominal pain is specific to the causative pathology, the following general measures may be useful in the management of acute abdominal pain.[my.ilstu.edu]
  • So it is manifested by localized abdominal pain and tenderness. Intestinal abscess mostly occurs in the appendix which is located in the right lower abdomen, and hence severe abdominal pain is present in this quadrant.[geocities.ws]
Abdominal Tenderness
  • tenderness R10812Left upper quadrant abdominal tenderness R10813Right lower quadrant abdominal tenderness R10814Left lower quadrant abdominal tenderness R10815Periumbilic abdominal tenderness R10816Epigastric abdominal tenderness R10817Generalized abdominal[cms.gov]
  • Signs – abdominal tenderness and adnexal tenderness on bimanual pelvic exam. Labs – decreased hematocrit; quantitative serum β-HCG radioimmunoassay is positive. Diagnosis confirmed by pelvic ultrasonography.[clinicaladvisor.com]
  • 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]
  • tenderness ** (n) コーパス 腹部アンギナ K551 ** ふくぶあんぎな PubMed , Scholar , Google , WikiPedia abdominal angina * (n) 腹部エコー *** ふくぶえこー PubMed , Scholar , Google , WikiPedia 【類義語】 腹部エコー検査 , 腹部超音波 , 腹部超音波検査 abdominal ultrasound ** (n) コーパス 腹部エコー検査 *** ふくぶえこーけんさ PubMed[lsd-project.jp]
  • Can easily confuse with PID Objective · Physical exam reveals abdominal tenderness, RLQ tenderness, abnormal bowel sounds, /- rebound · Patient usually wants to hold still, not to move around · Psoas sign/Obturator sign Assessment/Not to be missed · Keep[my.ilstu.edu]
Chronic Abdominal Pain
  • Chronic abdominal pain usually may be evaluated in a more unhurried manner.[my.ilstu.edu]
Palpitations
  • Heart yin vacuity pattern Main symptoms: Heart palpitations which are worse at night, fearful throbbing, heart and chest pain with a burning hot sensation, restlessness sometimes, insomnia, night sweats, heat in the heart of the palms of the hands and[books.google.com]
  • Symptoms include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down. The nurse is preparing a discharge teaching plan for the client who had an umbilical hernia repair.[quizlet.com]
Night Sweats
  • Heart yin vacuity pattern Main symptoms: Heart palpitations which are worse at night, fearful throbbing, heart and chest pain with a burning hot sensation, restlessness sometimes, insomnia, night sweats, heat in the heart of the palms of the hands and[books.google.com]
Night Sweats
  • Heart yin vacuity pattern Main symptoms: Heart palpitations which are worse at night, fearful throbbing, heart and chest pain with a burning hot sensation, restlessness sometimes, insomnia, night sweats, heat in the heart of the palms of the hands and[books.google.com]
Fear
  • Heart yin vacuity pattern Main symptoms: Heart palpitations which are worse at night, fearful throbbing, heart and chest pain with a burning hot sensation, restlessness sometimes, insomnia, night sweats, heat in the heart of the palms of the hands and[books.google.com]
  • Me, who was afraid to leave my house in fear of an "attack." I have told everyone I know to read your book. As soon as I started reading I just knew you were right.[gutsense.org]
  • Medication Note: There is the idea that due to the fear of masking abdominal symptoms, analgesics should not be given until a probable diagnosis is made and a course of treatment is determined.[my.ilstu.edu]
Burning Sensation
  • sensation rising from the stomach into the chest or towards the neck, it is most likely due to GERD The classic symptoms of GERD of heartburn and/or regurgitation may often be exacerbated by alcohol and certain foods, including those containing caffeine[my.ilstu.edu]
  • The burning sensation emanates from the esophageal mucosa, unprotected from digestive juices and enzymes. Barrett‘s esophagus (change of mucosa, precursor to cancer), dysphagia ( difficulty swallowing ), ulceration, bleeding, and esophageal cancer.[gutsense.org]
Insomnia
  • Heart yin vacuity pattern Main symptoms: Heart palpitations which are worse at night, fearful throbbing, heart and chest pain with a burning hot sensation, restlessness sometimes, insomnia, night sweats, heat in the heart of the palms of the hands and[books.google.com]
Pelvic Pain
  • CASE #30….23yo F with pelvic pain. Enter the name for this tabbed section: Case Case: A 23yo female presents with acute onset severe lower abdominal pain that woke her from sleep 5 hours prior to presentation. Pain is constant.[emergencyultrasoundteaching.com]
  • . · Study published in 2004 describes symptom pattern suggestive of ovarian cancer: pelvic pain, abdominal pain, difficulty eating, bloating, increased abdominal size, and urinary urgency.[my.ilstu.edu]
  • The development of right lower quadrant or pelvic pain may be the first symptom. The diagnosis of ruptured ectopic pregnancy should be relatively easy. The presence of a pelvic mass and elevated levels of chorionic gonadotropin are characteristic.[intranet.tdmu.edu.ua]
Incontinence
  • الصفحة 510 - Urinary Incontinence in Adults: Clinical Practice Guideline. AHCPR Pub. No. 92-0038. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services. ‏[books.google.com]
  • […] phase R1313Dysphagia, pharyngeal phase R1314Dysphagia, pharyngoesophageal phase R1319Other dysphagia R140Abdominal distension (gaseous) R141Gas pain R142Eructation R143Flatulence R150Incomplete defecation R151Fecal smearing R152Fecal urgency R159Full incontinence[cms.gov]
  • Fecal Incontinence. The loss of anal sphincter control causes an uncontrolled escape of stools.[gutsense.org]
Urinary Incontinence
  • الصفحة 510 - Urinary Incontinence in Adults: Clinical Practice Guideline. AHCPR Pub. No. 92-0038. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services. ‏[books.google.com]

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]
  • ., reducing bowel perforation and associated infectious complications). 39 Conversely, time-consuming or unnecessary imaging (or other diagnostic workup) may delay the indicated treatment and increase the risk of complications or result in false positive[effectivehealthcare.ahrq.gov]
  • Previous laboratory workup was unremarkable. Abdominal US positive for cholelithiasis without cholecystitis; abdominal CT otherwise negative for acute process. On exam, she was noted to have diffuse abdominal tenderness and a positive Murphy’s sign.[emergencyultrasoundteaching.com]
  • The role of microbiologic workup of infected fluid has been debated in the last years. Since the causative pathogens can easily be predicted in community acquired infections, bacteriological diagnosis is not necessary.[wjes.biomedcentral.com]
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.[merckmanuals.com]

Treatment

  • In addition, the text addresses the complex interface exists between the medical and surgical management of IBD with important information on medical treatment, endoscopic evaluation, pathology, radiology, and etiology.[books.google.com]
  • Your outcome will depend on the cause of your infection and how quickly you sought treatment. The right early treatment can significantly improve the outcome for people who develop intra-abdominal abscesses.[hopkinsmedicine.org]
  • Treatment The recurring themes of treatment in peritonitis are: a) resuscitation, b) antibiotics, c) peritoneal lavage, and d) source control 4.2.1.[ptolemy.ca]
  • Once-daily ertapenem is an interesting option for the treatment of these infections.[wjes.biomedcentral.com]
  • Treatment is percutaneous or surgical drainage; antibiotics are necessary but alone are not adequate treatment.[merckmanuals.com]

Prognosis

  • Prognosis Abscess The prognosis has improved considerably with the advent of drainage under CT scanning. Deaths are generally due to the underlying disease process or unsuspected foci of infection.[patient.info]
  • Prognosis The introduction of computed tomography (CT) scanning for the diagnosis and drainage of intra-abdominal abscesses has led to a dramatic reduction in mortality rates. (See Computed Tomography.)[medsurgeindia.com]
  • Prognosis Intra-abdominal abscesses have a mortality rate of 10 to 40%. Outcome depends mainly on the patient’s primary illness or injury and general medical condition rather than on the specific nature and location of the abscess.[merckmanuals.com]
  • Prognosis The introduction of computed tomography (CT) for the diagnosis and drainage of intra-abdominal abscesses has led to a dramatic reduction in mortality. (See Workup, Computed Tomography.)[emedicine.medscape.com]
  • Conclusions Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with a poor prognosis.[wjes.biomedcentral.com]

Etiology

  • In addition, the text addresses the complex interface exists between the medical and surgical management of IBD with important information on medical treatment, endoscopic evaluation, pathology, radiology, and etiology.[books.google.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.[merckmanuals.com]
  • Risk of subphrenic abscess increases to 10–30% if: Preoperative perforation of a hollow viscus Significant fecal contamination of the peritoneal cavity Bowel ischemia Immunosuppression Delayed diagnosis and treatment of peritonitis Etiology and Pathophysiology[unboundmedicine.com]
  • Most common etiologies include: Appendix – acute appendicitis. Ileocecal junction – terminal ileitis (infectious, Crohn’s disease), irritable bowel syndrome. Cecum – cecal volvulus and intestinal obstruction, cecal perforation.[clinicaladvisor.com]

Epidemiology

  • Epidemiology Incidence The specific incidence of subphrenic abscess is not well known; occurs after 1–2% of abdominal surgeries Most subphrenic abscesses are right-sided.[unboundmedicine.com]
  • Bowen JC, Brenner HL, Ferrante WA, Maule WF (1992) Gallstone disease pathophysiology, epidemiology, natural history and, treatment options. Med Clin North Am 76: 1143–1157 Google Scholar 2.[link.springer.com]
  • Epidemiology The incidence depends on the cause. In a hospital setting the prevalence of SBP is around 10%. [ 3 ] Three studies of patients with perforated appendicitis found an incidence of postoperative abscess formation of 20%.[patient.info]
  • Epidemiology and pathophysiology of intraabdominal infections (IAI). [Review] [26 refs]. Infection 26(5):329-34, 1998;-Oct. (15) Laroche M, Harding G. Primary and secondary peritonitis: an update. [Review] [79 refs].[ptolemy.ca]
  • Visceral abscesses Liver Abscesses Epidemiology and etiology Pyogenic liver abscesses occur in several settings, including biliary tract infection, direct extension from a contiguous site of infection, portal bacteremia from intra-abdominal septic foci[what-when-how.com]
Sex distribution
Age distribution

Pathophysiology

  • Associated pathophysiologic effects may become life threatening or lead to extended periods of morbidity with prolonged hospitalization.[medsurgeindia.com]
  • Risk of subphrenic abscess increases to 10–30% if: Preoperative perforation of a hollow viscus Significant fecal contamination of the peritoneal cavity Bowel ischemia Immunosuppression Delayed diagnosis and treatment of peritonitis Etiology and Pathophysiology[unboundmedicine.com]
  • Bowen JC, Brenner HL, Ferrante WA, Maule WF (1992) Gallstone disease pathophysiology, epidemiology, natural history and, treatment options. Med Clin North Am 76: 1143–1157 Google Scholar 2.[link.springer.com]
  • […] cholecystitis mesenteric ischemia and infarction post-operative complications penetrating trauma Causative organisms can include: enterobaceteriacae anaerobes streptococci E coli Bacteroides fragilis Staph and Strep following trauma/surgery return to top Pathophysiology[sharinginhealth.ca]

Prevention

  • Semi-fowlers aids in drainage and prevents spread of infection throughout the abodominal cavity.[quizlet.com]
  • Hepatic Problems Cirrhosis and Chronic Liver Failure Best treatment is prevention, with emphasis on: - reducing alcohol consumption - limiting occupational hepatotoxin exposure, and - preventing parenteral transmission of hepatitis B and C.[my.ilstu.edu]
  • They develop as the body’s immune system attempts to treat the infection and prevent it from spreading.[myvmc.com]
  • The development of pyogenic membranes may prevent spread to other compartments. (Reproduced from Meyers.6) Fig. 3-59. Abscess of Morison's pouch.[barnardhealth.us]
  • Peritonitis and intraabdominal abscesses Infectious Diseases The Clinician's Guide to Diagnosis, Treatment, and Prevention. 2003; : 144-53 2. Spellerberg B, Brandt C. Streptococcus Manual of clinical microbiology. 2011; : 331-49 3.[jjmicrobiol.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!