Post Surgical Abscess Question...

I can only tell you about my abscess experience. Had a drain bag inserted for about 3 weeks. Had about 10 weeks of antibiotics via PICC line from emergency colectomy and subsequent abscess.

Hi ATXGUY,

Intra-abdominal abscess are collections of infectious fluid in the abdomen. Right after surgery some fluid in the abdomen is normal. However, infectious fluid that collects into a pocket are referred to as an abcess. Abcesses often form 1 week to 3 months after surgery. From J-Pouch surgery can be caused by a few different things.

1) Pouch Leakage: If there is any pouch leakage, the bacteria that escapes will cause an infection.

2) Anastomosis Leak: The connections that are made, pouch/anus particularly can leak and cause an infection.

3) General Contamination: Bacteria spillage is always a real risk during surgery and the surgical site can become contaminated.

Treatment: The primary way to treat an abcess is by Drainage. A drain is inserted, often through the buttocks muscle and is left in for several weeks. The drain collapses the pocket and allows the abscess to heal.

Antibiotics: These are used but are often not effective by themselves. The problem is that the antibiotics cannot penetrate a large abcess.

After the abcess is acutely treated, the source of infection needs to be understood. If the pouch or connection sites are leaking, takedown surgery is often delayed. Surgical revisions are often needed.

My wife had 3 incidences of abcess after her pouch surgery. The first was drained, put on cipro/flagyl. The took the drain out and she was back in ER 1 week later. Second drain was placed and put on Augmentin for 2 weeks. Two months later, 3rd abcess was found, but was too small to drain. They put here on a long 2 month course of Augmentin which seemed to work.

No real bacteria was ever cultured and they concluded that her abcesses were due to contamination.

Her takedown was 3 weeks ago. No problems.

Keep an eye on the fever and the tailbone/back pain. They should also be able to tell by your bloodwork if you have an active infection. My wife's white blood cell count was around 25k for several weeks.

Dan

My drain bag was inserted on my abdominal left side. Guess I was just one big leaking infectious mess after my colon perforated in multiple places.

Thank you Dan.

Really solid information. I see my surgeon today, so I'll be sure to make sure to ask when he doesn't think I need a drain...

best,

b.