Surgical strategies for the management of severe intra-abdominal infection

Abstract

During the last century, advances in anti-microbial therapy, operative techniques, early diagnosis, and intensive care environments have produced a profound decrease in mortality from intra-abdominal infection (IAI). This improvement reached a plateau with severe intra-abdominal infections (SIAI) such as fecal peritonitis, diffuse suppurative peritonitis, or necrotizing pancreatitis. These entities do not respond to traditional therapies and continue to exhibit high mortality rates. During the last 15 years, aggressive surgical approaches have been proposed and implemented in an effort to further improve survival. The purpose of this review is to define severe intra-abdominal infection and to review the developments and caveats of surgical management.