[Tertiary peritonitis: as difficult to define as it is to treat]

Related Experiment Video

Updated: Jun 4, 2026

Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis
06:45

Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis

Published on: December 18, 2010

Alejandro Martín-López1, Sergio Castaño-Ávila, Francisco Javier Maynar-Moliner

  • 1Servicio de Medicina Intensiva, Hospital Santiago, Vitoria-Gasteiz, Álava, España. alejandro.martinlopez@hotmail.com

Cirugia Espanola
|January 29, 2011
PubMed

Insights

Tertiary peritonitis, a severe complication of intra-abdominal infections, lacks a clear definition, complicating diagnosis and treatment. Prevention is crucial due to its high mortality rate.

Area of Science:

  • Infectious Diseases
  • Surgical Pathology
  • Critical Care Medicine

Context:

  • Tertiary peritonitis represents a severe, delayed complication arising from complicated intra-abdominal infections.
  • Diagnosis and management are hindered by the absence of a universally accepted definition.
  • This condition necessitates aggressive, multidisciplinary interventions.

Purpose:

  • To provide a comprehensive review of tertiary peritonitis, addressing its definitions, risk factors, pathophysiology, and microbiological aspects.
  • To highlight the challenges in diagnosing and treating this severe clinical condition.
  • To emphasize the critical role of prevention strategies.

Summary:

  • Tertiary peritonitis is characterized by persistent infection despite initial treatment, often involving multi-resistant bacteria.
  • Management includes early, repeated surgeries, broad-spectrum antibiotics, and intensive supportive care.
  • Despite maximal interventions, mortality rates remain high, underscoring the importance of preventative measures.

Impact:

  • This review aims to standardize the understanding and approach to tertiary peritonitis, potentially improving patient outcomes.
  • Clarifying diagnostic criteria and treatment protocols can lead to more effective management strategies.
  • Highlighting preventative measures may reduce the incidence and associated mortality of this severe condition.

Related Concept Videos

Gastritis III: Clinical Manifestations and Management01:23

Gastritis III: Clinical Manifestations and Management

The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Intestinal Obstruction II: Pathophysiology01:07

Intestinal Obstruction II: Pathophysiology

Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
Peptic Ulcer01:27

Peptic Ulcer

Peptic ulcers are erosive lesions of the gastric or duodenal lining, most commonly caused by Helicobacter pylori infection. This Gram-negative, helical bacterium has adapted to survive the stomach’s acidic environment by producing urease, which converts urea into ammonia and carbon dioxide. The ammonia neutralizes gastric acid in the bacterium’s immediate environment, allowing colonization of the gastric mucosa. H. pylori attaches to mucus-secreting epithelial cells, penetrates the mucus...
Appendicitis01:19

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...