Intraabdominal abscess after penetrating abdominal trauma

In 57 (2.4 percent) of 2,416 patients undergoing laparotomy for penetrating abdominal trauma from 1977 to 1980, an intraabdominal abscess developed in the postoperative period. Preoperative antibiotic administration, careful closure of gastrointestinal tract perforation with diversion as necessary, and copious irrigation of the peritoneal cavity at the completion of surgery were common factors in all operations. Over 80 percent of penetrating wounds leading to abscesses occurred in the upper quadrants, and common risk factors included multiple intraabdominal solid organ injuries requiring open drainage, coupled with gastrointestinal tract perforation. Physician delay in the recognition of patients with intraabdominal abscess and in reoperation was a common problem.