An interloop abscess refers to a collection of pus confined between intestinal loops, mesentery, and omentum. These abscesses may be solitary or multiple, varying in size. Extensive adhesions around the abscess can lead to varying degrees of adhesive intestinal obstruction. Patients may present with symptoms of suppurative infection, along with abdominal distension, abdominal pain, abdominal tenderness, or palpable masses. An upright abdominal X-ray may reveal widened inter-bowel spacing, localized intestinal gas accumulation, or small bowel air-fluid levels. Treatment includes the use of antibiotics, physical heating therapies, and systemic supportive care.
If the abscess spontaneously ruptures into the intestinal lumen or bladder, an internal fistula could form, allowing pus to be discharged through feces or urine. For cases where non-surgical treatment is ineffective or intestinal obstruction occurs, exploratory laparotomy should be considered to relieve the obstruction, remove the pus, and perform drainage. Careful dissection during surgery is necessary to avoid injury to the intestinal loops and the risk of intestinal fistula formation. When ultrasound or CT imaging indicates a well-localized, unilocular abscess in proximity to the abdominal wall, ultrasound-guided percutaneous catheter drainage may also be an option.