Abscess

An abscess is an encapsulated collection of pus in a body cavity not preformed, produced by inflammatory Gewebseinschmelzung.

The subphrenic abscess ( located under the diaphragm ), the perityphlitische abscess (next to the vermiform appendix located ) and the Douglasabszess are seen pathologically no abscesses, but encapsulated empyema in the abdominal cavity.

Diagnostics

• Clinical signs: only in superficial abscesses: redness and swelling
• Pain and distension caused by swelling
• Fever, chills

• In the ultrasonic
• ( possible additional density determination ) in computed tomography or magnetic resonance imaging

• Visible pus
• Positive bacterial culture ( and resistogram )

Cause

Abscesses can occur without apparent external cause. But they can also be a result of an operation, a syringe, a foreign body or be favored by a weak immune system of the person concerned.

The plurality of abscesses caused by an infection with bacteria. Pathogens in chronic occurrence often a form of Staphylococcus aureus.

But there are also rare, sterile abscesses, from which pus can not isolate pathogens.

The superficial abscesses show a typical inflammatory reaction with heating ( hyperthermia) in the area. There are rare but also cold abscesses without such a typical case of tuberculosis. To an abscess, the body builds up a protective wall of granulation tissue, the so-called abscess. In this edge bead of the body concentrated defense cells. As present in the blood do not diffuse in antibiotic normally through this membrane at a sufficient concentration in the abscess cavity, the sole antibiotic is therapeutically often not sufficient.

Causes of the mouth, jaw and facial area

Bacterial infections that emanate from teeth or periodontal ligaments are called odontogenic infections. You can be the cause for the formation of an abscess in this region of the body.

Disease-related causes

There are some disease -related causes of abscesses. Here should be mentioned, for example, the Furunkolose or pyoderma. But the acne inversa ( hidradenitis suppurativa ) may be mainly the cause for recurrent abscesses in the large flexor regions of the body like armpits, groin, buttocks, rump. But not every abscess is equal to such a severe chronic inflammatory dermatosis.

Complications

If an abscess is not treated adequately or improperly, it can empty fistulous through the skin, break into body cavities or hollow organs or spread through the bloodstream, causing a brain abscess or other organ abscesses or at worst a sepsis ( " blood poisoning" ) to death of the person concerned lead.

Therapy

The treatment consists in opening and draining the pus. This takes the form of an operation in which flushed the abscess cavity by opening and emptying and a drain is inserted. In inaccessible abscesses, as often in the abdominal cavity or the retroperitoneum percutaneous puncture and drainage is performed under sonographic or CT guidance. For larger or poorly accessible abscesses surgery under anesthesia ( general anesthesia, spinal anesthesia or regional anesthesia ) is done. In exceptional cases Weichteilabszesse be opened in local infiltration anesthesia, but which carries a risk of cross-contamination in and less effective than other anesthetic procedures.

In general, and in particular in sepsis treatment with one or more antibiotics in addition can be considered.

Quote

The Greek philosopher and physician Hippocrates assigned quote is still valid indefinitely for the treatment of abscess:

" Ubi pus, ibi evacua. "

"Where is pus, there deflate him."