Four types: visceral (hepatic and splenic), nonvisceral (subphrenic and pelvic), intraperitoneal and extraperitoneal.
Visceral abscesses formed by extension of bacterial infection into the liver or spleen.
Nonvisceral abscesses arise after the resolution of peritonitis following a ruptured viscus, or the breakdown of an anastomosis.
Intra and extra peritoneal abscesses can result from hematogenous or lymphatic spread of infection.
Most are a result of postoperative complication of surgery on the colon, pancreas and biliary systems.
Those abscesses not second to surgery are caused by perforation of a viscus with localized inflammation.
Usually confirmed by ultrasound or abdominal/pelvic CT scan, which may show extraluminal gas or soft tissue changes.
Management is by drainage since antibiotics do not penetrate abscesses well.
Intraabdominal abscess-drainage can be achieved by percutaneous or surgical techniques.
Complex and multiple abscesses best drained by surgical techniques.
Percutaneous drainage is pref2242ed treatment for appendiceal abscesses because of a lower complication rate and shorter hospital stays.