This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (84)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

W. Douglas Pitcher, MD; Daniel M. Musher, MD

Arch Surg. 1982;117(3):328-333.

Abstract
• The overall mortality in 77 cases of intra-abdominal infection (IAI) was 39%. A striking correlation was observed between delay in definitive medical or surgical treatment, the number of medical and surgical complications, and mortality. Only one of 29 patients who showed a rapid clinical response to appropriate antibiotic treatment and/or an exploratory operation died, compared with 29 of 48 who did not, justifying a vigorous diagnostic approach with repeated exploratory surgery when necessary. Results of abdominal ultrasound and gallium scanning altered management in a meaningful fashion far less frequently than might be inferred from earlier reports. Factors contributing to delays in instituting definitive therapy included failure to recognize the presence of IAI, prolonged observation in the absence of noticeable response to medical therapy, the desire for confirmation by ancillary studies, and the argument that the patient was "too sick" to undergo surgery.

(Arch Surg 1982;117:328-333)

Author Affiliations
From the Infectious Diseases Section, Department of Medicine, Veterans Administration Medical Center, and the Departments of Medicine, Microbiology, and Immunology, Baylor College of Medicine, Houston.

Footnotes
Accepted for publication May 13, 1981.

Reprint requests to Infectious Diseases Section, VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77211 (Dr Musher).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Timing of Reoperation for Patients With Severe Peritonitis
Dellinger
JAMA 2007;298:923-924.
FULL TEXT  

Postoperative Intra-abdominal Sepsis Requiring Reoperation: Value of a Predictive Index
Pusajo et al.
Arch Surg 1993;128:218-223.
ABSTRACT  

Guidelines for Clinical Care: Anti-infective Agents for Intra-abdominal Infection: A Surgical Infection Society Policy Statement
Bohnen et al.
Arch Surg 1992;127:83-89.
ABSTRACT  

Nosocomial Abscess: Results of an Eight-Year Prospective Study of 32284 Operations
Olson and Allen
Arch Surg 1989;124:356-361.
ABSTRACT  

Improved Treatment of Intra-abdominal Abscess: A Result of Improved Localization, Drainage, and Patient Care, Not Technique
Deveney et al.
Arch Surg 1988;123:1126-1130.
ABSTRACT  

Design and Conduct of Antibiotic Trials: A Report of the Scientific Studies Committee of the Surgical Infection Society
Solomkin et al.
Arch Surg 1987;122:158-164.
ABSTRACT  

C-Reactive Protein Levels Predict Postoperative Septic Complications
Mustard et al.
Arch Surg 1987;122:69-73.
ABSTRACT  

Operative vs Percutaneous Drainage of Intra-abdominal Abscesses: Comparison of Morbidity and Mortality
Olak et al.
Arch Surg 1986;121:141-146.
ABSTRACT  

Radiologic Diagnosis of an Intra-abdominal Abscess: Do Multiple Tests Help?
Dobrin et al.
Arch Surg 1986;121:41-46.
ABSTRACT  

Intra-abdominal Abscess Unassociated With Prior Operation
Field and Pickleman
Arch Surg 1985;120:821-824.
ABSTRACT  

Controlled Open Drainage of Severe Intra-abdominal Sepsis
Bradley et al.
Arch Surg 1985;120:629-631.
ABSTRACT  

Severity of Illness in Intra-abdominal Infection: A Comparison of Two Indexes
Skau et al.
Arch Surg 1985;120:152-158.
ABSTRACT  

Surgical Infection Stratification System for Intra-abdominal Infection: Multicenter Trial
Dellinger et al.
Arch Surg 1985;120:21-29.
ABSTRACT  

A Proposed Classification of Intra-abdominal Infections: Stratification of Etiology and Risk for Future Therapeutic Trials
Meakins et al.
Arch Surg 1984;119:1372-1378.
ABSTRACT  

Laparotomy for Intra-abdominal Sepsis in Patients in an Intensive Care Unit
Sinanan et al.
Arch Surg 1984;119:652-658.
ABSTRACT