American Board of Internal Medicine (ABIM) Certification Practice Exam

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What size of abscess in diverticulitis typically requires percutaneous drainage?

Greater than 1 cm
Greater than 2 cm
Greater than 3 cm
Greater than 4 cm

The correct answer is: Greater than 3 cm

In cases of diverticulitis, the size of the abscess plays a significant role in determining the management strategy. Abscesses that are larger than 3 cm typically warrant percutaneous drainage. This is because larger abscesses are more likely to cause significant symptoms such as pain and fever, and smaller abscesses may resolve with conservative management, including antibiotics and dietary modifications. Percutaneous drainage is a minimally invasive procedure that can effectively relieve symptoms and eliminate the infection associated with a large abscess. Research and clinical guidelines suggest that abscesses larger than 3 cm are less likely to resolve spontaneously, emphasizing the need for intervention. Therefore, when an abscess exceeds this threshold, percutaneous drainage is usually recommended to promote recovery and prevent complications such as perforation or abscess rupture.