An abscess is a limited accumulation of pus in tissues or organs due to inflammation with tissue fusion and cavity formation.
The cause of an abscess is the penetration of pyogenic microbes into the tissues (through abrasions, injections, wounds). Microorganisms can get in as a result of accidental wounds or are brought in during medical manipulations (injections, subcutaneous injections), produced without observing the rules of asepsis.
An abscess can develop with acute purulent inflammation of any organ (lung), skin, and subcutaneous tissue, in particular with furunculosis, carbuncle, phlegmon, lymphadenitis, etc. It can form at the site of hemorrhage or hematoma (hematoma suppuration). Frequent abscesses due to hematogenous metastasis with general purulent infection (metastatic abscesses).
Diagnosis of symptoms and course of an abscess
Abscesses that can be caused by all types of microflora are very diverse in size and location. Usually occur in the center of the inflammatory infiltrate, only metastatic abscesses are located far from the main inflammatory focus. The shape of their cavity ranges from simple rounded to complex with numerous pockets and blind passages. Swelling and hyperemia (redness) of the skin are visible above the abscess, which is not observed only with its deep location.
In acute inflammation, the symptom of fluctuation, or swelling, is very important. It is explained by the presence of fluid (pus) trapped in a cavity with elastic walls that transmit a shock wave in all directions. There is no symptom when the wall is very thick and the abscess is small and deep. You can confirm the diagnosis with a test puncture of the cavity with a thick needle for the presence of pus.
In a chronic abscess, the above signs of acute inflammation may be almost completely absent.
A breakthrough of an abscess into any cavity (joint, pleura, etc.) is a serious complication. Especially dangerous are abscesses located in the internal organs (liver, lungs) and near large veins. The possible consequences of their breakthrough are purulent pleurisy, peritonitis, or the transition of inflammation to the vein wall with the development of progressive thrombophlebitis.
Purulent-inflammatory processes (before the formation of a purulent cavity) are treated with conservative methods, local and parenteral antibiotics.
Small abscesses with low virulence flora can be cured by repeated punctures with the suction of pus and the introduction of a solution of antibiotics. Indications and urgency of the operation are determined by the degree of intoxication. With a small abscess, you can limit yourself to one incision, repeated are required with a significant accumulation of pus and leaks. The incisions should correspond to the direction of the skin folds, and on the limbs, they should be determined by the lines of flexion of the joints, i.e. in its position and size, to ensure a good outflow of pus.
Deep abscesses are opened with a preliminary trial puncture. After the pus is drawn from the needle, it is left in place as a guide through which the incision is made. Patients with an abscess with a pronounced general reaction are hospitalized in a purulent surgical department.