Monday, February 16, 2015

Study group discussion: Most common site of intraperitoneal abscess

Which is the most common site of intraperitoneal abscess?

It's pelvic.

The reason being gravity, common sites are subphrenic, paracolic, pelvic and right iliac fossa.

Pelvic is most common due to pelvic position of appendix and fallopian tubes, and due to leakages from colorectal surgeries.

I had a MCQ asking me to choose between paracolic, subphrenic and pelvic and stuff as options for the most common site.

So in that case, what would be the answer?

Pelvic would be the most common site, according to my teachers.

What is the best way to get to a pelvic abscess sample?

Through rectum? They usually burst into rectum and resolve.

In women, from the umm what do you call it..
Pouch of Douglas!

Nice Ikan :)

I tried so hard to recall the name. Almost blanked out for a moment there!

In women vaginal drainage is done.. Through posterior fornix vaginl drainage in women.

And if the abscess is pointing in rectum, rectal drainage is done.

In males, you would pass a needle through the rectum

Laparotomy is almost never necessary and rectal drainage is preferred over suprapubic which risks exposing the general peritoneal cavity to infection.

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