Intra-abdominal abscess in older patients: two atypical presentations to the Acute Medical Unit

An abscess is a localised collection of necrotic tissue, white cells and bacteria, collectively forming pus. Intra-abdominal abscesses can occur viscerally (e.g. hepatic abscess), retroperitoneally (e.g. psoas abscess) or intraperitoneally (e.g. subphrenic abscess).(1, 2) Clinical presentation is variable and largely depends on the site of abscess. Fever and abdominal pain are the classic symptoms although in older people presentation can be non-specific. Prompt diagnosis and early intervention are vital for good outcomes.(3) We present two cases of older women whose presentation with atypical symptoms resulted in a delay in diagnosis.