Obstruction following abdominal abscesses

Peritoneal pus sometimes obstructs the gut. The patient presents with the symptoms of obstruction, and you have to take a careful history to find out that they started with some form of sepsis, such as an appendicitis, a pelvic abscess, or a tubo[nd]ovarian abscess. Suspect that this has happened: (1) If pain and fever preceeded the obstructive symptoms, or, (2) you can feel a tender indurated area abdominally, vaginally, or rectally. The patient has no signs of general peritonitis, and his bowel sounds are exaggerated. A raised white count is suggestive. Treat him with nasogastric suction, intravenous fluids, and antibiotics, and drain his abscess as necessary (6.3). His obstruction will usually be relieved as you drain it. If not, you will have to operate and try to free the obstruction.