[Tertiary peritonitis: as difficult to define as it is to treat].
Tertiary peritonitis is the most delayed and severe outcome of patients with complicated intra-abdominal infections. The major difficulty lies in giving a common, precise and consensus definition in order to know when to make its diagnosis and how it can be avoided and/or treated. This condition requires early and repeated surgery, wide spectrum antibiotic therapy against multi-resistant bacteria and intensive systemic support measures. Despite all this, the prognosis is extremely poor since it has a mortality which can reach up to 60%, with preventions being the most important measure to avoid it developing. In this article, we have made a specific review of tertiary peritonitis, of the accepted definitions, the risk factors, its pathophysiology, the microbiological flora involved, and its treatment.
Servicio de Medicina Intensiva, Hospital Santiago, Vitoria-Gasteiz, Álava, España. alejandro.martinlopez@hotmail.com
Alejandro
A
Martín-López
Sergio
S
Castaño-Ávila
Francisco Javier
FJ
Maynar-Moliner
José Antonio
JA
Urturi-Matos
Alberto
A
Manzano-Ramírez
Héctor Pablo
HP
Martín-López
D006801:Humans; D010538:Peritonitis / Q000145:classification / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy*