Pelvic Abscess
Pelvic abscess
- MC site of an intraperitoneal abscess
- Diarrhea and passage of mucus in stools
- Rectal examination: bulging of anterior rectal wall
- Majority of abscesses burst into the rectum and rapid recovery follows
- In women, vaginal drainage through posterior fornix is chosen
- Rectal drainage is preferable over suprapubic drainage
- Laparotomy is never necessary
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Left subphrenic space |
Right subphrenic space |
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Causes of abscess
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Causes of abscess
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Left subhepatic space/lesser sac |
Right subhepatic space |
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Clinical features
- Pus some-where, pus no-where else, pus under the diaphragm
- Plain X-ray: elevated diaphragm (tented diaphragm)
- USG or CT is the investigation of choice
- Radiolabelled white cell scanning when other techniques have failed
Exam Question
- Vaginal drainage of a pelvic abscess (posterior colpotomy) is indicated when a pelvic abscess extends into the pouch of Douglas.
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