Diagnosis and management of intra-abdominal sepsis

Intra-abdominal infections are commonly encountered in the general medical/surgical intensive care unit (ICU). Perhaps the largest group of these patients has recently undergone or will shortly undergo some form of interventional procedure. There have been important advances in supportive care, diagnostic tools, anti-infective therapy, and interventional techniques; resulting in both improved care and new controversies in the management of these critically ill patients. Most notable is the role of routine non-invasive imaging for suspected intra-abdominal infections, its use in monitoring success of therapy, and the role of percutaneous or laparoscopic intervention to replace formal laparotomy. The continuing development of antibiotics has provided a novel opportunity for tailoring therapy to the requirements of the individual.