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Surgical management of intra-abdominal infection: is there any evidence?

Moshe Schein1

  • 1Cornell University College of medicine, New York, NY, USA. Mschein1@mindspring.com

Langenbeck'S Archives of Surgery
|May 1, 2002
PubMed

Insights

Surgical treatment for secondary bacterial peritonitis remains controversial. Planned relaparotomy and laparostomy, while lacking strong evidence, are suggested as life-saving interventions for severe intra-abdominal infections in select patients.

Area of Science:

  • Surgical Gastroenterology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Secondary bacterial peritonitis is a severe intra-abdominal infection.
  • Adequate source control and peritoneal toilet are essential but controversial aspects remain.

Purpose of the Study:

  • To review evidence supporting surgical treatment for secondary bacterial peritonitis.
  • To examine controversial surgical modalities: planned relaparotomy and laparostomy.

Main Methods:

  • Review of existing literature on surgical management of secondary bacterial peritonitis.
  • Analysis of evidence regarding planned relaparotomy and laparostomy.

Main Results:

  • Limited high-quality evidence supports or refutes planned relaparotomy and laparostomy.
  • Clinical experience suggests these are critical for severe intra-abdominal infections.

Conclusions:

  • Planned relaparotomy with laparostomy is a powerful tool for severe intra-abdominal infections.
  • These modalities can be life-saving in carefully selected patients.
  • Judicious application and knowing when to cease intervention are crucial.

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