General Abdomen: Intraabdominal Fluid Collections

Seroma

Definition

  • Definition: Serous Fluid Collection
  • Serve as a Nidus for Infection

Treatment

  • Asymptomatic: Nothing
  • Symptomatic or Persistent (> 6-8 Weeks): Aspirate

Infectious Fluid Collections

Phlegmon

  • Definition: Area of Inflamed Tissue, Not Walled-Off

Abscess

  • Definition: Confined Infection, Walled-Off
  • Retroperitoneal Causes
    • Primary: Hematogenous Spread
    • Secondary (Most Common): Adjacent Infection
      • Most Common Source: Renal Infection
  • Tx: Percutaneous Drain & ABX
    • ABX Duration: 4 Days After Source Control
      • *Based on the STOP-IT Trial
    • Indications for Surgical Drainage: Interloop or Mesenteric
      • Should Also Resect Any Involved Bowel

CT Showing a Phlegmon (Arrow) of the Cecum 1

CT Showing an Intraabdominal Abscess (Arrow) Behind the Stomach

References

  1. To H, Stella DL, Chandra R. Infiltrating caecal carcinoma versus appendicitis with caecal phlegmon-can computer tomography differentiate them? J Surg Case Rep. 2017;2017(2):rjx006. (License: CC BY-NC 4.0)