What type of emergency are intra-abdominal infections usually?
Medical-surgical emergencies.
What is the prognosis often associated with intra-abdominal infections?
Frequently life-threatening.
What is the reference examination for intra-abdominal infection?
Computed tomography.
Which imaging method sometimes supplements computed tomography in intra-abdominal infections?
Ultrasonography.
What are the main microorganisms in intra-abdominal infections?
Enterobacteriaceae, anaerobes, and enterococci.
What percentage of enterococci is typically found in intra-abdominal infections?
Less than 10%.
What type of organisms may be involved in nosocomial intra-abdominal infections?
Multidrug-resistant organisms.
What causes acute appendicitis?
Intraluminal obstruction followed by mucosal inflammation and bacterial superinfection.
Between which ages does acute appendicitis most often occur?
Between 10 and 25 years of age.
What are typical symptoms of acute appendicitis?
Right iliac fossa pain and tenderness or guarding.
What fever range is typical in acute appendicitis?
38–38.5°C.
Which gastrointestinal symptoms are common in acute appendicitis?
Constipation, nausea, and vomiting.
What does management of acute appendicitis usually involve?
Emergency surgery, sometimes by laparoscopy.
How long can antibiotics be given after appendicitis surgery?
From 0 to 5 days depending on findings and complications.
What is the antibiotic duration if surgery is not performed for appendicitis?
7 days.
What is peritonitis?
Inflammation of the peritoneum, localized or generalized.
What causes secondary peritonitis?
An intra-abdominal infectious focus like organ perforation.
How does primary peritonitis usually occur?
As a rare, monomicrobial hematogenous infection.
What clinical sign describes a board-like abdomen in peritonitis?
Abdominal rigidity.
What emergency treatments are required for peritonitis?
Peritoneal lavage, drainage, microbiological sampling, surgery, supportive care, and antibiotics.
How long is antibiotic treatment for mild community-acquired peritonitis?
2 to 3 days.
What is the antibiotic treatment duration for generalized peritonitis?
4 days.
How long is antibiotic treatment for postoperative nosocomial peritonitis?
8 days.
What is sigmoid diverticulitis?
An infection of colonic diverticula.
At what age does sigmoid diverticulitis most often occur?
Between 60 and 70 years of age.
What are typical symptoms of sigmoid diverticulitis?
Left iliac fossa pain, fever 38–38.5°C, constipation, localized guarding, and painful rectal exam.
What are the main complications of sigmoid diverticulitis?
Perforation with peritonitis, abscess, stenosis causing obstruction, and diverticular bleeding.
What is the usual treatment duration for sigmoid diverticulitis with antibiotics?
Seven days of empirical antibiotics.
When can sigmoid diverticulitis be treated without antibiotics?
In spontaneously favorable uncomplicated disease with symptomatic treatment.
When is surgery indicated in sigmoid diverticulitis?
For complications such as abscess or perforation.
What mainly causes biliary tract infections?
Obstruction from gallstones or tumors mainly causes biliary tract infections.
What is acute cholecystitis?
Acute cholecystitis is acute infection of the gallbladder caused by prolonged cystic duct obstruction.
What are typical symptoms of acute cholecystitis?
High fever with chills, sudden intense right hypochondrial pain, positive Murphy sign, and possible radiation to back or shoulder.
What does ultrasound typically show in acute cholecystitis?
Wall thickening over 3 mm, gallstones, or cystic duct dilatation.
How is acute cholecystitis treated?
Urgent empirical antibiotics, analgesics, and cholecystectomy for complicated cases, usually within 48 hours.
What defines acute cholangitis?
Infection with main bile duct obstruction presenting with right hypochondrial or epigastric pain, fever, and jaundice.
What lab findings occur in acute cholangitis?
Inflammatory syndrome, cytolysis, cholestasis, increased conjugated bilirubin, and 50% positive blood cultures.
What is the treatment approach for acute cholangitis?
Urgent antibiotics and analgesics followed by biliary drainage; antibiotics continue 3 days after drainage.
What are the two main types of hepatic abscesses?
Pyogenic and amoebic hepatic abscesses.
What is the usual microbial origin of pyogenic hepatic abscesses?
They are usually polymicrobial, often from biliary or colonic origin.
Which bacteria are commonly found in pyogenic hepatic abscesses?
Gram-negative bacilli like Escherichia coli and Klebsiella, anaerobes, and Gram-positive cocci.
What symptoms do hepatic abscesses typically cause?
Fever and right hypochondrial pain radiating to the shoulder, worsened by shaking the liver.
Which imaging methods diagnose hepatic abscesses?
Computed tomography and biliary ultrasound.
When is image-guided percutaneous aspiration used in hepatic abscess diagnosis?
When needed to determine abscess number, size, and location.
What does treatment of hepatic abscesses combine?
Empirical antibiotics for 4–6 weeks and percutaneous radiological drainage for large abscesses or peritoneal signs.
When is surgery indicated for hepatic abscesses?
For complications such as perforation or peritonitis.
When should an intra-abdominal infection be suspected?
When abdominal pain is associated with fever.
What does diagnosis of intra-abdominal infection rely on?
Appropriate imaging.
What is the management approach for intra-abdominal infection?
Combined medical-surgical management.
Test your knowledge with 24 questions on Intra-Abdominal Infections.
1. Which statement best characterizes the clinical significance of most intra-abdominal infections?
2. Which imaging study is considered the reference examination for suspected intra-abdominal infection?
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