Factors Affecting the Successful Management of Intra-Abdominal Abscesses With Antibiotics and the Need for Percutaneous Drainage

PURPOSE: METHODS: RESULTS:Sixty-seven of 114 patients (59 percent) had intra-abdominal abscesses resulting from appendicitis, diverticulitis in 30 patients (26 percent), postoperative in 13 patients (11 percent), and undetermined in 4 patients (4 percent). Three patients (3 percent; 95 percent confidence interval, 1-8 percent) failed conservative management and underwent urgent operation. Sixty-one (54 percent; 95 percent confidence interval, 44-63 percent) patients improved with intravenous antibiotic therapy alone. Fifty patients (44 percent; 95 percent confidence interval, 35-54 percent) underwent image-guided percutaneous drainage after 48 to 72 hours of antibiotic therapy. Patients who improved on antibiotics alone had average abscess diameter of 4 cm, whereas patients who underwent percutaneous drainage had average diameter of 6.5 cm (P < 0.0001). Maximal temperature at time of admission was 100.8°F for antibiotic group and 101.2°F for percutaneous drainage group (P = 0.0067). CONCLUSIONS: