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Abdominal abscess. A surgical strategy.

P L Glick, C A Pellegrini, S Stein

    Archives of Surgery (Chicago, Ill. : 1960)
    |May 1, 1983
    PubMed
    Summary
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    For abdominal abscess treatment, direct drainage is more effective than laparotomy. Direct drainage achieved higher success rates and lower mortality, making it the preferred initial approach.

    Area of Science:

    • Abdominal Surgery
    • Infectious Diseases

    Background:

    • Abdominal abscesses pose significant treatment challenges.
    • Laparotomy and extraserosal drainage are established treatment modalities.

    Purpose of the Study:

    • To compare the efficacy of direct drainage versus laparotomy for abdominal abscesses.
    • To reassess the role of laparotomy in current abdominal abscess management.

    Main Methods:

    • Retrospective analysis of 79 patients undergoing 97 operations for 120 abdominal abscesses over five years.
    • Comparison of outcomes between direct drainage (66 episodes) and laparotomy (31 episodes).

    Main Results:

    • Direct drainage resulted in sepsis resolution in 80% with a single operation and a 12% mortality rate.

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  • Laparotomy resulted in sepsis resolution in 61% with a single operation, with a 19% mortality rate.
  • Incorrect preoperative diagnosis significantly reduced therapy success rates.

    • Conclusions:

    • Direct drainage is the preferred initial approach for accurately diagnosed abdominal abscesses.
    • Exploratory laparotomy is reserved for cases with unsuccessful preoperative localization or persistent sepsis.
    • Laparotomy is also indicated for concomitant surgical abdominal conditions.