<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>The present paper was done to review common diagnostic techniques used to help surgeons find the most suitable way to diagnose postoperative intra-abdominal sepsis (IAS). The topic was searched on MEDLINE, Embase, and Cochrane Library databases. Collected articles were classified and checked for their quality. Findings of selected research were included in this study and analyzed to find the best diagnostic method for intra-abdominal sepsis. IAS presents severe morbidity and mortality, and its early diagnosis can improve the outcome. Currently, there is no consensus among surgeons on a single diagnostic modality that should be used while deciding reoperation in patients with postoperative IAS. Though it has a high sensitivity for abdominal infections, computed tomography has limited applications due to mobility and time constraints. Diagnostic laparoscopy is a safe process that produces usable images, and can be used at the bedside. Diagnostic peritoneal lavage (DPL) has high sensitivity, and the patients testing positive through DPL can be subjected to exploratory laparotomy, depending on severity. Abdominal Reoperation Predictive Index (ARPI) is the only index reported as an aid for this purpose. Serial intra-abdominal pressure measurement has also emerged as a potential diagnostic tool. A proper selection of diagnostic modality is expected to improve the outcome in IAS, which presents high mortality risk and a limited time frame.</p>
</abstract>

The present paper was done to review common diagnostic techniques used to help surgeons find the most suitable way to diagnose postoperative intra-abdominal sepsis (IAS). The topic was searched on MEDLINE, Embase, and Cochrane Library databases. Collected articles were classified and checked for their quality. Findings of selected research were included in this study and analyzed to find the best diagnostic method for intra-abdominal sepsis. IAS presents severe morbidity and mortality, and its early diagnosis can improve the outcome. Currently, there is no consensus among surgeons on a single diagnostic modality that should be used while deciding reoperation in patients with postoperative IAS. Though it has a high sensitivity for abdominal infections, computed tomography has limited applications due to mobility and time constraints. Diagnostic laparoscopy is a safe process that produces usable images, and can be used at the bedside. Diagnostic peritoneal lavage (DPL) has high sensitivity, and the patients testing positive through DPL can be subjected to exploratory laparotomy, depending on severity. Abdominal Reoperation Predictive Index (ARPI) is the only index reported as an aid for this purpose. Serial intra-abdominal pressure measurement has also emerged as a potential diagnostic tool. A proper selection of diagnostic modality is expected to improve the outcome in IAS, which presents high mortality risk and a limited time frame.

Diagnostic challenges in postoperative intra-abdominal sepsis in critically ill patients: When to reoperate?

Department of Surgery, College of Medicine

Majmaah University, Ministry of Education

Postępy Higieny i Medycyny Doświadczalnej

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The present paper was done to review common diagnostic techniques used to help surgeons find the most suitable way to diagnose postoperative intra-abdominal...

Criteria	Score
Respiratory failure	2
Renal failure	2
Alterations in consciousness	2
Emergency surgery (at initial operation)	3
Ileus (72 hours after surgery)	4
Abdominal pain (48 hours after surgery)	5
Persistent symptoms (4th day after surgery)	6
Wound infection	8

Criteria	Scores
Systolic blood pressure (≤100 mmHg)	1
Change in mental status	1
Respiratory rate (≥22/min)	1

Diagnostic challenges in postoperative intra-abdominal sepsis in critically ill patients: When to reoperate?

Article Category: Review

Publicado en línea: 14 oct 2022

Páginas: 420 - 430

Recibido: 04 nov 2021

Aceptado: 14 mar 2022

DOI: https://doi.org/10.2478/ahem-2022-0032

Palabras clave
intra-abdominal sepsis, diagnostic laparoscopy, diagnostic peritoneal lavage, Abdominal Reoperation Predictive Index (ARPI), Serial Intra-abdominal pressure

© 2022 Nasser A N Alzerwi, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

Fig. 2

Scores of the Abdominal Reoperation Predictive Index (ARPI)

Scores of the Quick Sequential Organ Failure Assessment (qSOFA)

Diagnostic challenges in postoperative intra-abdominal sepsis in critically ill patients: When to reoperate?

Article Category: Review

Publicado en línea: 14 oct 2022

Páginas: 420 - 430

Recibido: 04 nov 2021

Aceptado: 14 mar 2022

DOI: https://doi.org/10.2478/ahem-2022-0032

Palabras claveintra-abdominal sepsis, diagnostic laparoscopy, diagnostic peritoneal lavage, Abdominal Reoperation Predictive Index (ARPI), Serial Intra-abdominal pressure

© 2022 Nasser A N Alzerwi, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

Fig. 2

Scores of the Abdominal Reoperation Predictive Index (ARPI)

Scores of the Quick Sequential Organ Failure Assessment (qSOFA)

Palabras clave
intra-abdominal sepsis, diagnostic laparoscopy, diagnostic peritoneal lavage, Abdominal Reoperation Predictive Index (ARPI), Serial Intra-abdominal pressure