Surgical Approach to Peritonitis and Abdominal Sepsis
Scientists stress out the fact that adequacy and timing are very important in such cases because an untimely, improper and incorrect operation will surely have many negative effects on the patient in comparison with the medical therapy. Surgery will be recommended depending solely on the type, process and severity that the intra-abdominal infection will have.
In most cases, the gravity of the case will clearly outline the necessity of such a procedure as in cases of peritonitis due to ruptured appendix, ischemic colitis or colonic diverticula.
The surgeon should try to diagnose as clear and soon as possible the characteristics of the disease prior to the operation so that risks that would involved it would be to a minimum. However, in cases of abdominal sepsis, cases that will be delayed in operative management will surely lead to a significantly higher need in the future for reoperation and will worsen the outcome.
The intervention in such a case will include resection on the perforated viscus with the help of re-anastomosis or by creating a fistula. In trying to reduce the bacterial load that will be presented, there will be made a perforation into the lavage of the abdominal cavity, taking special attention to the areas that will be prone to some abscess formation for example the subphrenic area or the paracolic gutters.
In treating abdominal infections, laparoscopy has gained a much wider acceptance than in the past, due to the newly surgical procedures that where developed, in trying to have minimum to no risks what so ever. The outcome to any surgery like this will solely depend on the gravity of the disease and the experience and skill of the laparoscopic surgeon.
It is highly recommended that you would search for some one that has undergone this procedures many times and has a lot of work experience in the field to diminish any chances of complications during or after the surgery. This type of procedure has been associated with a short stay in the hospital and fewer complications and wounds then the open approach.
Although highly recommended, there are cases in which the patient will develop intra-abdominal abscess due to the nature of the operation and will need after it a specific treatment. In comparing the laparoscopic peritoneal lavage to the open Hartmann’s procedure for the perforated diverticulitis with a generalized peritonitis, there has always been a heated debated which one would be the most effective. Both procedures will present some negative effects on the patients’ due to the nature of them but at the vary same time it will solely depend on the gravity in which the disease present itself and on the medical history of the patient and of the doctor as well.
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