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Diagnosis / Abscess

An abscess is an infected fluid collection within the body, most commonly in the abdomen and pelvis.

Abdominal abscesses may form below the diaphragm, in the middle of the abdomen, in the pelvis, or behind the abdominal cavity. Abscesses also may form in or around any abdominal organ, such as the kidneys, spleen, pancreas, or liver, or in the prostate gland. Untreated abscesses can grow and damage nearby blood vessels and organs. Sometimes, bacteria enter the bloodstream (sepsis) and spread to distant organs and tissues. This can spread can be fatal.

In order to confirm a diagnosis of an abscess your doctor may order an imaging test, such as a CT scan or an ultrasound.

What Causes an Abscess?

In some cases, abdominal abscesses are caused by perforation of the intestine due to cancer, ulcer, or injury. More commonly, abscesses are caused by the spread of infection or inflammation caused by conditions such as appendicitis, diverticulitis, Crohn disease, pancreatitis, or pelvic inflammatory disease.

Some abscesses form after an acute injury to the abdomen or after surgery.

What are the Symptoms of an Abscess?

Specific symptoms of abdominal abscesses depend on the location of the abscess, but most people have constant discomfort or pain, feel generally sick (malaise), and often have a fever. Other symptoms could include loss of appetite and weight loss.

The below symptoms are likely based on the site of the abscess:

  • Below the diaphragm – cough, painful breathing, and pain in one shoulder
  • Mid-abdomen – usually painful in the area of the abscess
  • Pelvis – abdominal pain, diarrhea caused by intestinal irritation, and an urgent or frequent need to urinate caused by bladder irritation.
  • Abdominal cavity – pain, usually in the lower back, worsens when the person moves the leg at the hip.
  • Pancreas – fever, abdominal pain, nausea, and vomiting often being a week or more after a person recovers from pancreatitis.
  • Liver – loss of appetite, nausea, and a fever. A person may or may not have abdominal pain.
  • Spleen – pain in the left side of the abdomen, the back, or the left shoulder.

How is an Abscess Diagnosed?

If doctors suspect a person has an abscess, they will usually use imaging tests to distinguish an abscess from other problems, as well as determine the source, size and position. Some standard imaging tests are computed tomography (CT), ultrasound, or magnetic resonance imaging (MRI).

To make a definitive diagnosis, doctors sometimes insert a needle thought the skin to draw a sample of pus from the abscess; this is called a needle aspiration. The sample will then be examined in a laboratory to identify the infecting organism so the most effective antibiotic can be selected.

What are my Treatment Options?

Despite the widespread use and availability of antibiotics, most infected fluid collections that are within the abdominal cavity need to be treated actively either by percutaneous drainage or by surgery. Due to the advancements in image-guided techniques most intra-abdominal or intra-pelvic abscesses can be drained percutaneously.

Antibiotics are usually used in addition to drainage to prevent the infection from spreading and to help completely eliminate the infection. It is uncommon for antibiotics to cure an abscess without drainage.

IVC’s Treatments for an Abscess

At IVC, we offer a minimally invasive treatment for abscess drainage. Percutaneous abscess drainage, uses image guidance to obtain a sample of the infected fluid and remove infected fluid from the body.

Call IVC today at 503-612-0498 to schedule an appointment for a consultation.

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Jason Bauer, MD RVT
Michael Pfister, MD RVT

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