What is a Diverticulitis Abscess?

A diverticulitis abscess forms when infection accumulates and seeps from a perforation within an inflamed diverticula in one’s digestive system. Considered a complication of diverticulitis, the formation of an abscess can greatly compromise digestive function and place the individual at risk for further complications. Treatment for a diverticulitis abscess generally necessitates catheter placement for drainage purposes and, in some cases, may require surgery to remove any remaining infection.

Diverticulum are pockets that form in weakened colonic tissue, a condition known as diverticulosis, that have the potential to trap waste as it moves through the lower portion of the digestive tract. The accumulation of waste material, namely fecal matter, within the pockets can contribute to inflammation and the development of infection. Additionally, decreased circulation in the affected colonic tissue may also cause inflammation and leave the area susceptible to infection. Individuals with diverticulosis frequently develop diverticulitis, a condition characterized by the inflammation of the diverticulum.

Individuals with diverticulitis often experience abdominal discomfort accompanied by fever, nausea, and vomiting. Ordinarily, the condition may be treated with antibiotic medication and subside without incident. In cases where a perforation, or tear, has developed in the colonic tissue, infection may seep into the abdominal cavity and form a diverticulitis abscess.

In many cases, a diverticulitis abscess may remain undiagnosed until symptom progression prompts imaging and blood tests that detect it. In the presence of a diverticulitis abscess, one’s symptoms will usually become more pronounced and severe in presentation. Individuals will usually develop abdominal distention and tenderness, anal bleeding or an obvious disruption in the regularity of their bowel movements, which can necessitate extensive testing to determine the cause of the bowel obstruction.

The formation of an abscess occurs when pus and infection accumulate in a centralized location, such as within the soft tissues of the colon and surrounding abdominal area. The severity of the abscess usually determines the treatment approach. If the abscess is small and noninvasive to surrounding tissues, it may be treated with antibiotics and require no further treatment. When the abscess continues to grow despite antibiotic treatment, catheter placement may be necessary to drain the abscess and prevent further growth and complications.

Known as percutaneous catheter drainage, this outpatient procedure involves the introduction of a small catheter through the skin into the abscess. A local anesthetic is applied to the administration site and image-guided technology, such as ultrasound, is utilized to aid with catheter placement. Once the area is properly anesthetized, a small needle is used to introduce an intravenous tube that delivers the catheter to the abscess where it remains until the contents of the pustule have been completely extracted. In some cases, a more invasive, secondary procedure may be utilized to remove any remaining infection or pus. Extreme cases of infection that become invasive to surrounding tissues may necessitate the partial or complete removal of the lower portion of the colon.

If treatment is delayed or absent, the individual is at risk for peritonitis, which is considered a medical emergency. Peritonitis occurs when an abscess ruptures and its contents leak into the abdominal region. Those who develop this life-threatening condition may experience abdominal distention, extreme thirst, and reduced urine and fecal output. If left untreated, peritonitis can induce shock and, ultimately, lead to death.