Peritonitis and Intra-abdominal Abscess – Pelvic and Sub-phrenic

Introduction

Treatment of intra-abdominal infections is without doubt one of the most common and important challenges for surgeons generally and for those who work in low-income countries, in particular. Despite the development of much ancillary diagnostic technology, the diagnosis of peritonitis is still dependent on clinical criteria. Operative management, which may require repeated laparotomies, may tax the skills of the most experienced surgeon.

A multi-disciplinary approach to intensive care support of the critically ill patient may be as important to survival as surgery. Controlling the source of infection, removing contamination by peritoneal lavage, antibiotics and physiologic support remain the chief modalities of treatment. (2) Intra-abdominal infections comprise a) infections of specific organ systems, eg. appendicitis, and cholecystitis; b) peritonitis resulting from extension of infection into the general peritoneal cavity and c) intra-abdominal abscesses which result from the extension of inflammation beyond the viscus and from incompletely resolved peritonitis. (3) The latter two entities comprise the subject of this Review.