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Intra-Abdominal Abscess: What Is It & How Are They Treated?

Let’s talk about the above mentioned. It is rarely blogged about but it has been a common feature in my life and many others who suffer from Crohn’s disease. I have had 8 of these over the last decade, it’s inconvenient, uncomfortable and in all honesty, I should know better but thought the last one at the onset was a sports injury until I realised that I no longer had the relevant muscles to hurt that I started to have a panic.

As always this is written from my point of view and personal experience, I am not a medical professional and this is purely an advice/ guidance post.

My history 

My long history with abdominal abscesses has been a long one, most assume and advise that you need to take a hot bath, add salts or use the hot flannel method to bring it up so that it can burst, others will also advise to lance it yourself.

CAN I PLEASE IMPLORE THAT IF YOU HAVE AN ABSCESS YOU NEED TO SEEK MEDICAL ADVICE AND ASSISTANCE!!! THESE CAN LEAD TO A SEPSIS RISK IF NOT TREATED WITH ANTIBIOTICS, SOME MAY NEED DRAINING SURGICALLY.

My recurrent abscesses started after my reconstructive surgery in 2012. They are always on the right side of my abdomen, some come to the surface, others have needed to be scraped down to wound bed and others have been aspirated, I had one that burst, the feeling of relief and pressure was absolutely amazing but I required a long course of antibiotics and had to see the wound nurse as the site still needed intervention and burnt with silver nitrate sticks due to granulation tissue around the site. 

My last abscess left me in the hospital for 10 days, looking like I was six months pregnant and rather poorly as well as being in some substantial pain.

I was put onto a medicated liquid diet whilst they decided my treatment plan as the abscess was very close to my stoma site and my Crohn’s has been confirmed as active. My abscess was drained via ultrasound with a drain port being placed into the abscess and then having it drained out by a rather big syringe. My abscess contents thankfully not faecal based so this lowered the risk of a fistula developing after the abscess drainage. I had the drain left in situ, this was removed last week after being in place for just over 4 weeks as it was no longer draining,  I am still on antibiotics for a further 4 weeks to make sure the abscess doesn’t come back.  

I am just thankful that this one was surgically drained, it meant that I didn’t have to deal with an open wound. 

What is an intra-abdominal abscess?

  • – An intra-abdominal abscess is a collection of pus or infected fluid that is surrounded by inflamed tissue inside the belly.
  • – An intra-abdominal abscess may be caused by bacteria. If left untreated, the bacteria will multiply and cause inflammation and kill healthy tissue
  • – If you’ve recently had surgery or trauma to an abdominal organ and have other risk factors, such as diabetes or inflammatory bowel disease, be on the lookout for signs of an intra-abdominal abscess.
  • – Early treatment can significantly improve the outcome for people who develop intra-abdominal abscesses

Symptoms 

  • – Fever
  • – Hot and cold sweats
  • – Nausea
  • – Pain in the abdomen
  • – Lack of appetite
  • – A hard mass in the abdomen
  • – Change in bowel habits

The usual tests to diagnose an abscess

  • – Bloods
  • – Imaging scans
  • – Physical examination

How is an intra-abdominal abscess treated?

Antibiotics may help treat an infection that could lead to an intra-abdominal abscess. But once the abscess has developed, antibiotics don’t work as well for treatment. An intra-abdominal abscess often will need to be drained of fluid in order to heal. Typically, however, antibiotics are given along with draining the abscess. The type of antibiotic will depend on how severe your abscess is, your age, and any other conditions you may have.

One way to remove fluid is through percutaneous drainage. This is a short procedure that involves guiding a needle through the skin to the location of the infection. Your healthcare provider will give you a sedative and a local anesthetic to help you relax and eliminate any discomfort or pain while it is being done. 

Another way to drain the abscess is with surgery. Surgical procedures may also involve repairing the condition that caused the abscess in the first place, such as a bowel perforation. Sometimes, more than one operation is needed.

Many times, a drainage catheter is left in the abscess cavity after it is drained. This will be checked by the healthcare team and removed when appropriate.

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.  

While you are being treated for an intra-abdominal abscess, you may need nutritional support such as a feeding tube.

Summary

I had to laugh after all of this as this abscess may have been caused by my panproctocolectomy surgery, my best advice is don’t touch Google, stay well away, always seek medical advice, Facebook groups are helpful but you can’t compare your symptoms to another person when it comes to things like this as it is a risk to your health, please always seek medical advice with your GP, GI or Surgical consultant, the quicker these are dealt with the easier the recovery and end result. 

As always 

Many thanks for reading 

Louise Xx

This blog post is intended to give advice to ostomates. The information given is based on Louise’s personal experience and should not be taken as clinical advice. Each ostomates needs are unique to them and their stoma care routine. Please consult with your Stoma Care Nurse before undertaking any changes to your stoma care routine or if you are experiencing any health issues.

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