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Intraabdominal infection and acute abdomen

Acute abdomen refers to a heterogenous group of urgent conditions characterized by the sudden onset of severe abdominal pain. The spectrum of disease encompassed within this term may cause diagnostic difficulty, owing to the considerable diversity in the underlying etiology, which includes, among others, obstructive, inflammatory, vascular, infective, and gynecological processes. Infective intraabdominal processes in particular are a serious cause of mortality and present a unique clinical challenge due to the evolutionarily dynamic nature of the pathogens and the potential for progression of infection beyond the original infectious foci. As a result, diagnosis and management of patients with suspected intraabdominal infections is contingent on obtainment of a comprehensive history, structured evaluation, timely intervention, and prompt initiation of empiric therapy, followed by adjustments in antimicrobial therapy once the causative organism has been identified, if necessary.

Author: Tamara Skříšovská, Petr Štourač, Hiroko Martin

Institution: Faculty of Medicine at Masaryk University in Brno

Medical discipline: Emergency Medicine

Keywords: intraabdominal infection | peritonitis | acute diverticulitis | microbiology | pneumoperitoneum | antibiotics | virulence factors | bacteria | intestinal flora | bowel perforation | anaerobic bacteria

Educational evel: Undergraduate level | Graduate

Acute abdomen refers to a heterogenous group of urgent conditions characterized by the sudden onset of severe abdominal pain. The spectrum of disease encompassed within this term may cause diagnostic difficulty, owing to the considerable diversity in the underlying etiology, which includes, among others, obstructive, inflammatory, vascular, infective, and gynecological processes. Infective intraabdominal processes in particular are a serious cause of mortality and present a unique clinical challenge due to the evolutionarily dynamic nature of the pathogens and the potential for progression of infection beyond the original infectious foci. As a result, diagnosis and management of patients with suspected intraabdominal infections is contingent on obtainment of a comprehensive history, structured evaluation, timely intervention, and prompt initiation of empiric therapy, followed by adjustments in antimicrobial therapy once the causative organism has been identified, if necessary.


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Review

Acute abdomen refers to a medical emergency, arising from full health, characterized by rapid progress and potentially life threating without adequate swift treatment. The algorithm considers basic examinations, which must be performed as part of differential diagnosis, and further elaborates other procedures for correct diagnosis in this case - bowel perforation. Using the correct and incorrect answers, the microbiological diagnosis of secondary peritonitis agents is reminded. Starting from the principles of correct material collection to microbiological examination, through microscopic and subsequent culture determination of probable infectious agents and correct antimicrobial therapy given the specific pathogen. These are common acute conditions that every doctor encounters in daily practice and in the field of microbiological diagnostics are still accompanied by errors (decent wetting of the swab in the purulent content of the abdominal cavity instead of taking a tube full of pus). Due to this fact, this algorithm is a good teaching aid for future doctors.

publikováno: 5.6.2021 | last modified on: 5.6.2021