Does an abscess at the point of hookup of an ileostomy reversal usually mean a permanent colostomy?

Not always: I assume you mean an ileostomy that was taken down and reanastomosed. An abscess that appears within the first 10 days usually occurs from a leak. If the location is favorable, many abscesses can be drained through the skin using x-ray guidance thus avoiding the need for another operation and a colostomy.

Maybe: Abscess maybe do to infection or breakdown of the bowel connection need to consult your surgeon to discuss further.

Many things: You have had an ileostomy takedown and have a abscess at the anastomoses. You are concerned that a permanent diversion will be required. Many things need to be evaluated. The abscess can be drained by radiology. The distal bowel will be studied to make sure no distal blockage exists. You may need bowel rest but hopefully things will heal. Ask your surgeon and share your concerns.