management of a pericolic abscess

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The management of a pericolic abscess is either conservative or surgical.

Conservative treatment: the first line of treatment is as for acute diverticulitis. Antibiotic treatment contains the abscess and allows spontaneous drainage of the abscess into the bowel.

Surgical treatment: required if conservative treatment fails. This is a major operation. It involves diversion of the faecal stream forming a colostomy; also, abscess drainage and exploration, and, if inflammation is not too severe, removal of the piece of inflamed bowel.

The latter part of the operation can be undertaken electively several months later when the inflammation has subsided. The colostomy can be closed at this time or some time later.

Last reviewed 01/2018