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Cited by 46Abdominal Surgery and ComplicationsSepsis Diagnosis and TreatmentAppendicitis Diagnosis and Management

Interventional management of abdominal sepsis: when and how

Goor, H. van·2002·Langenbeck s Archives of Surgery
DOI 10.1007/s00423-002-0309-7
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Abstract

Background To decide "how and when to treat intra-abdominal infection" is one of the most important challenges for surgeons interested in abdominal sepsis. The minimally invasive approach to intra-abdominal infection, both diagnostic and therapeutic, has gained great popularity in recent years: the cause of infection is assessed as soon as possible by means of sophisticated radiography and minimally invasive surgery, patients with intra-abdominal infection are treated with the least surgical injury in order not to aggravate the systemic response ("second hit"), and clinicians rely on clinical scoring combined with new imaging techniques to decide for reintervention. In some patients with severe intra-abdominal infection damage control followed by a few planned relaparotomies seems necessary to provide a solid basis for the patient to start recovering. Paying close attention in these patients to maximal support vital systems and preventing local complications seems crucial for their eventual prognosis.Discussion In this context we discuss important surgical topics such as primary resection and anastomosis in perforated diverticulitis, planned relaparotomy vs. relaparotomy "on demand," intra-abdominal hypertension, and primary and delayed abdominal wall closure techniques after operation for severe intra-abdominal infection.

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  • Patients in intensive care suffering from shock, infection, or trauma react inadequately to a renewed challenge like surgery, the second hit phenomenon.

    “It has long been known that patients in intensive care suffering from shock, infection, or trauma react inadequately to a renewed challenge like surgery. This has also been called the phenomenon of the second hit.126, 127, 128, 129, 130, 131”

    From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [128]

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Authors
Goor, H. V.
Affiliations
Radboud University Medical Center (NL)
Corresponding author
Goor, H. van
Venue
Langenbeck s Archives of Surgery
Publisher
Springer Science and Business Media LLC
Published
2002-10-01
Volume
387
Issue
5-6
Pages
191-200
ISSN
  • 0023-8236 (ISSN-L)
  • 1435-2443
DOI
10.1007/s00423-002-0309-7
OpenAlex
W2112507369
Cited by
46
References
60
Citations by year
2025: 1 · 2024: 1 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 3 · 2015: 1 · 2013: 3 · 2012: 2
FWCI
0.54
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Langenbeck s Archives of Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Abdominal Surgery and Complications
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Emergency Medicine › Appendicitis Diagnosis and Management
Keywords
abdominal sepsis, intra-abdominal infection, minimally invasive surgery, damage control surgery, perforated diverticulitis, primary resection and anastomosis, relaparotomy, intra-abdominal hypertension, second hit, clinical scoring
MeSH terms
Anastomosis, Surgical, Compartment Syndromes, Drainage, Humans, Laparotomy, Laparoscopy, Reoperation, Surgical Mesh, Abdominal Abscess, APACHE

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