Treatment of the abscess on the abdomen
In the case of larger abscesses or if the patient’s general condition is poor, the treatment is usually surgical. Depending on where the abscess is located, the abscess membrane is usually split with a knife and the fluid in the abscess cavity is drained or aspirated. This is followed by sterile wound irrigation and finally closure.
Every abscess can form again at the same location and may have to be surgically repaired again. After the operation, the patient is usually given antibiotics for several days. Smaller abscesses, which can usually be spotted by random examinations, often do not have to be treated surgically but purely antibiotically. More on the topic: Surgery of an abscess.
Liver abscess
A liver abscess causes an accumulation of pus in the liver. The pus usually develops as a result of inflammation of the bile ducts (cholangitis) or the accumulation of bacteria in the blood which then enter the liver. In rare cases, the liver abscess can also be caused by fungi or amoebae.
The symptoms of liver abscess are relatively unspecific. Right-sided upper abdominal pain and fever may occur. In addition, affected persons can feel very weak.
In order to find the diagnosis, a blood sample should be taken to examine the inflammation parameters and liver values. The blood should also be examined for bacteria (blood culture). The ultrasound examination of the liver can reveal a liver abscess.
If the ultrasound examination does not provide clear results, a CT scan should be performed. Therapeutically, antibiotic therapy should be ordered and the abscess should be removed. To remove the abscess, a drainage is first inserted into the abscess through the skin. The insertion of the drainage is CT-guided. If the drainage therapy is not successful or not possible, the abscess must be removed surgically.
Splenic abscess
A splenic abscess is also called an intranal abscess. Spleen abscesses generally occur very rarely. It is an accumulation of pus in the spleen, which in most cases is caused by a systemic infection (sepsis).
In most cases, an inflammation of the heart valves (endocarditis) causes this systemic infection, which then triggers the splenic abscess. The inflammation can be caused by bacteria or fungi. In some cases, a splenic infarction (splenic tissue is no longer supplied with sufficient blood and dies) or an injury to the spleen can also lead to an accumulation of pus.
It is important that a splenic abscess is detected, as the abscess can cause tissue swelling and thus tear the capsule surrounding the spleen. Since the spleen is strongly supplied with blood, the rupture of the capsule can lead to a life-threatening bleeding. In addition to fever and fatigue, there is typically left-sided pain in the upper abdomen.
A blood test and ultrasound examination are carried out diagnostically. If the ultrasound does not provide any information, CT or MRI imaging can help. Therapy includes antibiotic therapy and abscess removal by means of a drainage insert through the skin or surgery.
