Persistent intra-abdominal abscess with intestinal obstruction following seven failed drainage procedures over 3.5...

Intra-abdominal abscesses are common post-operative complications, typically resolving with percutaneous drainage and antibiotics. Chronic, refractory abscesses persisting for years and progressing to mechanical bowel obstruction are exceedingly rare.

We report a 36-year-old female who developed a persistent intra-abdominal abscess following an ovarian cystectomy, with symptoms persisting for 3½ years despite seven drainage procedures and two exploratory laparotomies. She presented with progressive abdominal distension, vomiting, and signs of bowel obstruction. Imaging confirmed a chronic organized abscess abutting bowel loops. Definitive management included bowel and omental resection with restoration of bowel continuity. Histopathology revealed chronic suppurative inflammation without granulomas or malignancy.

This case highlights the need to consider chronic intra-abdominal abscess in the differential diagnosis of persistent post-operative symptoms and underscores the importance of timely surgical intervention in refractory cases to prevent progression to rare complications such as mechanical bowel obstruction.