Infection of the peritoneal cavity can be divided into acute peritonitis and chronic abscess formation. While acute peritonitis is easier to diagnose and treatment is often straightforward, the diagnosis of an intra-abdominal abscess can be subtle and treatment can involve multiple diagnostic and therapeutic modalities. The advent of high-quality computed tomography and ultrasonography has revolutionized the care of these patients, and has allowed for the definitive management of these infections without open operation. We review the current techniques for the diagnosis, localization, and treatment of these serious infections, discuss important factors influencing the decision between percutaneous and operative approaches, and examine several other controversies In this challenging area.
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