The challenge of post-operative peritonitis after gastrointestinal surgery.
Post-operative peritonitis (PP) is a life-threatening hospital-acquired intra-abdominal infection with high rates of mortality. Diffuse PP remains a challenge for surgeons. Prognosis and outcome of patients are directly related to early diagnosis and prompt intervention. The diagnosis of PP may be difficult because there are no specific clinical signs and laboratory tests to reject or confirm the diagnosis. Atypical clinical features may be responsible for a delay in reoperation. An early diagnosis and prompt treatment is crucial to prevent the development of organ failure and improve the outcome of the patients with PP. The cornerstones in the management of patients with PP are early hemodynamic support, prompt source control and adequate antimicrobial therapy.
Department of Surgery, Macerata Hospital, Via Santa Lucia, 2, Macerata, Italy. massimosartelli@gmail.com.
Massimo
M
Sartelli
Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK.
Ewen A
EA
Griffiths
Department of Surgery, Macerata Hospital, Via Santa Lucia, 2, Macerata, Italy.
Maurizio
M
Nestori
D057868:Anastomotic Leak; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004322:Drainage; D005440:Fluid Therapy; D006801:Humans; D010289:Parenteral Nutrition, Total; D010538:Peritonitis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D012769:Shock / Q000209:etiology / Q000628:therapy
D000900:Anti-Bacterial Agents
Leak; Peritonitis; Post-operative; Sepsis