Intra-Abdominal Abscess

Episode overview

Intra-abdominal abscesses can be easy to miss—especially when the skin incision looks completely normal. On the Surgery Shelf, the key is recognizing the postoperative pattern, knowing when to image, and understanding when drainage or surgery is the next best step. In this episode, Chris and Mars break down the classic presentation of intra-abdominal abscess, the role of CT imaging, and the core treatment principle of antibiotics plus source control. You’ll learn when percutaneous drainage is preferred, when operative management is necessary, and how hemodynamic instability changes the entire plan. We also review one of the most practical postoperative concepts: what your drain output is telling you. Clear fluid? Check creatinine for urine. Milky output? Check triglycerides for chyle. Pancreatic concern? Check amylase. Bilious drainage? Check bilirubin. Feculent output? Think bowel leak or fistula. Plus, we cover persistent fever after drainage, clogged or malpositioned drains, loculated collections, and key surgery shelf-exam traps that can change management.