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3.5.3 - Peritonitis and the Acute Abdomen

from Section 3.5 - Acute Gastrointestinal Failure

Published online by Cambridge University Press:  27 July 2023

By
Shona Johnson  and
Liza Keating
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. The acute abdomen requires prompt diagnosis and management to improve patient outcomes.

  2. 2. In the critically ill adult, causes of an acute abdomen can be broadly divided into mechanical, inflammatory and vascular.

  3. 3. Peritonitis is due to infection in most cases. It may be generalised or localised, and is further divided into primary, secondary and tertiary infection.

  4. 4. Acute mesenteric ischaemia is an uncommon vascular cause of the acute abdomen but is associated with high mortality.

  5. 5. Radiological findings are useful, although the diagnosis is mainly clinical.

Keywords

acute abdomenperitonitisintra-abdominal infectionacute mesenteric ischaemia
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 211 - 213
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Doherty, GM. The acute abdomen. Loeb, MS, Davis, K (eds). Current Diagnosis and Treatment: Surgery, 13th edn. New York, NY: McGraw-Hill; 2010. pp. 451–63.Google Scholar
Ellis, H, Calne, R, Watson, C. Peritonitis. In: Ellis, H, Calne, R, Watson, C (eds). Lecture Notes: General Surgery, 11th edn. Malden, MA: Blackwell Publishing; 2006. pp. 231–6.Google Scholar
Karvellas, CJ, Abraldes, JG, Arabi, YM, et al.; Cooperative Antimicrobial Therapy of Septic Shock (CATSS) Database Research Group. Appropriate and timely antimicrobial therapy in cirrhotic patients with spontaneous bacterial peritonitis-associated septic shock: a retrospective cohort study. Aliment Pharmacol Ther 2015;41:747–57.CrossRefGoogle ScholarPubMed
Mastoraki, A, Mastoraki, S, Tziava, E, et al. Mesenteric ischemia: pathogenesis and challenging diagnostic and therapeutic modalities. World J Gastrointest Pathophysiol 2016;7:125–30.CrossRefGoogle ScholarPubMed
Strachan, S, Soni, N. Intra-abdominal sepsis. In: Waldmann, C, Soni, N, Rhodes, A (eds). Oxford Desk Reference: Critical Care. New York, NY: Oxford University Press; 2008. p. 336.Google Scholar

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