Making use of high index of suspicion in diagnosing intra-abdominal abscess

Abstract

More than 80% of intra-abdominal abscesses occur in the postoperative period and the majority after pancreatico- biliary or colorectal surgery. Over 30% of abscesses are associated with clear evidence of anastomotic leak. There are no reliable signs or symptoms of intra-abdominal abscess. Huge abscesses containing more than 1 L of pus may occur without any significant physical finding. This case report describes a patient with generalized abdomen pain and abdominal distension after 2 weeks of headache and fever. After undergoing laparotomy for dealing with perforated typhoid ulcer of the ileum and 2nd operation for bowel leakage ,the patient health two weeks later was fair, but unexplained tiredness while leukocytosis was the only finding which encouraged 3rd operation during which intraabdominal abscesses were found and Corrugated drain was left. We may conclude that unexplained postoperative leukocytosis indicate hidden sepsis. Placing Intraabdominal corrugated drain may be invaluable in preventing recollection.

Keywords

• Interloop abscess
• intra-abdominal abscess
• perforated typhoid