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Postoperative intra-abdominal abscess — USMLE Step 3 MCQ

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HardSurgery (post-operative, follow-up)Postoperative intra-abdominal abscessUSMLE Step 3

A 52-year-old man is postoperative day 7 after sigmoid colectomy. He has worsening abdominal pain, fever, tachycardia, and ileus. WBC count is 18,000/microL. CT abdomen with contrast shows a 6-cm pelvic fluid collection with gas near the anastomosis. Which of the following is the most appropriate next step in management?

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Correct answer: D — Start broad-spectrum antibiotics and arrange percutaneous drainage

A postoperative abscess or contained anastomotic leak with systemic signs and a drainable collection requires source control, typically percutaneous drainage plus broad-spectrum antibiotics.

Reference: ACS/SHEA/SAGES surgical guidance