Intra-abdominal infections

Infecciones intra-abdominales

It is important to understand the defense mechanisms of the abdominal cavity as well as its different resident cells and diverse functions in the face of aggression, to generate an early and late peritoneal inflammatory response to infection. Knowing the different gastrointestinal flora allows us to understand the etiology and causal agents of inflammatory and infectious intrabdominal processes. The appropriate classification and diagnosis allow to establish an appropriate treatment, both in the antibiotic and surgical management; The different types of laparotomy for cleaning the erythematous cavity allow a better control of the infection and avoid possible complications that progress towards a systemic inflammatory response and multi-organ dysfunction. This article tries to cover these topics in order to have adequate knowledge for the management of intra-abdominal infections. Materials and methods: a literature search was carried out using key words in Medline, Cochrane and Pubmed, as well as guide texts. Results: from the numerous articles those that are mentioned at the end in the recommended readings were selected. Abbreviations: IIA, intra-abdominal infection; TBX, thromboxane; PGD, prostaglandins; IL, interleukin; IGF, insulin growth factors; TNF, tumor necrosis factor; PT, peritoneum; CABD, abdominal cavity.

* Christou NV, Barie PS, Dellinger EP, Waymack JP, Stone HH. Surgical Infection Society intra-abdominal infection study. Prospective evaluation of management techniques and outcome. Arch Surg. 1993 Feb;128(2):193-8.

* Malangoni MA. Evaluation and management of tertiary peritonitis. Am Surg. 2000 Feb;66(2):157-61.

* Moore EE, Burch JM, Franciose RJ, Offner PJ, Biffl WL. Staged physiologic restoration and damage control surgery. World J Surg. 1998 Dec;22(12):1184-90.

* Solomkin JS, Mazuski JE, Baron EJ, Sawyer RG, Nathens AB, DiPiro JT, Buchman T, Dellinger EP, Jernigan J, Gorbach S, Chow AW, Bartlett J; Infectious Diseases Society of America. Guidelines for the selection of anti-infective agents for complicated intra-abdominal infections. Clin Infect Dis. 2003 Oct 15;37(8):997-1005.

* Walker RI, Owen RL. Intestinal barriers to bacteria and their toxins. Annu Rev Med. 1990;41:393-400.