Tertiary peritonitis: A disease that should not be ignored

作     者：Hanna Santos Marques Glauber Rocha Lima Araújo Filipe Antônio França da Silva Breno Bittencourt de Brito Paulo Victor Dias Versiani Jaqueline Silva Caires Thiago de Carvalho Milet Fabrício Freire de Melo 

作者机构：Campus Vitória da ConquistaUniversidade Estadual do Sudoeste da BahiaVitória da Conquista 45083-900BahiaBrazil Instituto Multidisciplinar em SaúdeUniversidade Federal da BahiaVitória da Conquista 45029-094BahiaBrazil Department of SurgeryHospital Geral de Vitória da ConquistaVitória da Conquista 45029-094BahiaBrazil 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2021年第9卷第10期

页      面：2160-2169页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Tertiary peritonitis Pathogenesis Clinical manifestation Diagnosis Treatment Prognosis 

摘      要：Intra-abdominal infections can be classified into uncomplicated or complicated(peritonitis). Peritonitis is divided into primary, secondary, and tertiary. Tertiaryperitonitis is the less common but the most severe among peritonitisstratifications, being defined as a recurrent intra-abdominal infection that occurs48 h after a well-succeeded control of a secondary peritonitis. This disease has acomplex pathogenesis that is closely related to the capacity of the peritonealcavity to activate immunological processes. Patients who progress to persistentperitonitis are at an increased risk of developing several infectious complicationssuch as sepsis and multiple organ failure syndrome. Moreover, tertiary peritonitisremains an important cause of hospital death mainly among patients withassociated risk factors. The microbiological profile of organisms causing tertiaryperitonitis is often different from that observed in other types of peritonitis. Inaddition, there is a high prevalence of multidrug-resistant pathogens causing thiscondition, and an appropriate and successful clinical management depends on anearly diagnosis, which can be made easier with the use of clinical scorespresenting a good prediction value during the intensive care unit ***, immediate therapy should be performed to control theinfectious focus and to prevent new recurrences. In this sense, the treatment isbased on initial antimicrobial therapy and well-performed peritoneal drainage.