🩺 Section 419.3: Peritoneal Abscess (Acute Secondary Localized Peritonitis)

Nelson Textbook of Pediatrics 22nd Edition — Peritoneal abscess is a localized collection of pus within the peritoneal cavity, resulting from secondary peritonitis. Most common cause: perforated appendicitis (periappendiceal abscess). Other causes: Crohn disease, perforated viscus, postoperative. Sites: periappendiceal, pelvic, subphrenic, interloop, psoas. Diagnosis: CT (rim-enhancing fluid collection). Treatment: percutaneous drainage + antibiotics, followed by interval appendectomy (if appendiceal origin).

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📋 30 Clinical Scenarios — Peritoneal Abscess

📇 High‑Yield Review Cards (Peritoneal Abscess)

🩺 Clinical Presentations: Peritoneal Abscess

Select a presentation for diagnostic clues and management.

📋 Stepwise Evaluation & Management of Peritoneal Abscess

🔑 Key Principles — Peritoneal Abscess (Nelson 419.3)
• Most common cause: Perforated appendicitis → periappendiceal abscess.
• Common sites: Right lower quadrant (periappendiceal), pelvic (rectal tenesmus), subphrenic, interloop, psoas abscess.
• Diagnosis: Contrast-enhanced CT (rim-enhancing fluid collection).
• Treatment: Percutaneous drainage (CT or US-guided) + broad-spectrum antibiotics (piperacillin-tazobactam or ceftriaxone + metronidazole).
• Interval appendectomy: 4-6 weeks after resolution of abscess to prevent recurrence.

    ⚡ Reflex Prompts — Peritoneal Abscess Decisions

    📖 Peritoneal Abscess — Core Summary (Nelson 419.3)