Abdominal abscess - pre and post percutaneous drainage

Case contributed by Matthew Kaluza

Presentation

Morbidly obese patient with HIV presents with increasing right upper quadrant abdominal pain of one-week duration. The patient recently had a sleeve gastrectomy performed.

Patient Data

Age: 45 years
Gender: Female

The patient has a right subhepatic abscess measuring 13cm in diameter. There is no intrahepatic dilation. 

CT

Post CT-guided percutaneous drainage

Pigtail catheter placed by interventional radiology under CT guidance

Case Discussion

An intra-abdominal abscess is a rare complication of a laparoscopic sleeve gastrectomy occurring at a rate of 0.7% 1.

It is managed by percutaneous drainage or surgical drainage depending on the characteristics of the abscess.

The patient described immediate relief upon drainage. A JP bulb was left in place to finish draining the abscess. She is doing well on follow-up.

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