The Bucharest ESTES consensus statement on peritonitis

Diaconescu, Bogdan; Uranues, Selman; Fingerhut, Abe; Vartic, Mihaela; Zago, Mauro; Kurihara, Hayato; Latifi, Rifat; Popa, Dana Elena; Leppäniemi, Ari; Tilsed, Jonathan; Bratu, Matei Răzvan; Beuran, Mircea

doi:10.1007/s00068-020-01338-9

Cited by 5 publications

(4 citation statements)

References 117 publications

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“…According to the nature of penetration of microflora into the abdominal cavity, peritonitis is divided into primary, secondary and tertiary [7][8]. With primary peritonitis, there is no visible focus of infection in the abdominal cavity [9][10]. Microflora penetrates into the abdominal cavity mostly by hematogenous and lymphogenous routes.…”

Section: Methodsmentioning

confidence: 99%

A modern view of the causes and mechanisms of the development of acute disseminated peritonitis

Benedyct

Prodan

Bahrii³

et al. 2022

J Educ Health Sport

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Despite the fact that the diagnosis of acute peritonitis has improved in recent years, a wide range of antibiotics is available, and minimally invasive methods of surgical treatment have been implemented, the mortality rate for this disease is high and ranges from 12.5 % to 39.2 %. The purpose of the work was to analyze data from literary sources regarding the classification of acute peritonitis, to summarize the causes and mechanisms of its development among the adult population. Analytical and bibliosemantic research methods were used in the work. It is known that according to the nature of penetration of microflora into the abdominal cavity, peritonitis is divided into primary, secondary and tertiary. According to the clinical course, peritonitis is divided into acute, subacute and chronic. According to the nature of the exudate in the abdominal cavity, serous, serous-purulent, fibrinous, fibrinous-purulent, purulent, hemorrhagic, fecal and purulent peritonitis are distinguished. To date, the existing classifications are constantly being improved and have both practical and academic significance. It has long been known that the cause of unsatisfactory results of surgical treatment of patients with acute disseminated peritonitis can be the development of intra-abdominal hypertension with subsequent development of compartment syndrome and multiple organ failure. The development of multiple organ failure is the leading cause of death in patients with acute surgical pathology. Abdominal compartment syndrome plays a big role in this, the mortality in which reaches very significant figures – 42-68 % and without treatment approaches 100 %. Therefore, the development of acute peritonitis is due to numerous reasons (in particular, acute destructive appendicitis, cholecystitis, perforated ulcer of the stomach or duodenum, intestinal obstruction, tumor processes, gynecological pathology, abdominal injuries, etc.), which in turn causes the absence of a generally recognized justified classification.

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Section: Methodsmentioning

confidence: 99%

A modern view of the causes and mechanisms of the development of acute disseminated peritonitis

Benedyct

Prodan

Bahrii³

et al. 2022

J Educ Health Sport

View full text Add to dashboard Cite

show abstract

“…According to previous treatment methods, the relevant methods for the treatment of sepsis were divided into two main categories, the first category was the basic treatment methods for the characteristics of sepsis. Antibiotics decrease the release of inflammatory factors and mediators by regulating pathogenic microorganisms and the immune system to improve shock relieve clinical symptoms and signs of sepsis ( 140 , 141 ). Dopamine, a vasoactive drug, maintains a steady state of cardiac function by regulating the mean arterial tone ( 142 , 143 ).…”

Section: Conclusion and Future Research Prospectsmentioning

confidence: 99%

Sepsis‑induced cardiac dysfunction and pathogenetic mechanisms (Review)

Song,

Fang,

Zhou

et al. 2023

Mol Med Rep

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Sepsis is a manifestation of the immune and inflammatory response to infection, which may lead to multi-organ failure. Health care advances have improved outcomes in critical illness, but it still remains the leading cause of death. Septic cardiomyopathy is heart dysfunction brought on by sepsis. Septic cardiomyopathy is a common consequence of sepsis and has a mortality rate of up to 70%. There is a lack of understanding of septic cardiomyopathy pathogenesis; knowledge of its pathogenesis and the identification of potential therapeutic targets may reduce the mortality rate of patients with sepsis and lead to clinical improvements. The present review aimed to summarize advances in the pathogenesis of cardiac dysfunction in sepsis, with a focus on mitochondrial dysfunction, metabolic changes and cell death modalities and pathways. The present review summarized diagnostic criteria and outlook for sepsis treatment, with the goal of identifying appropriate treatment methods for this disease.

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“…• Stage I an abbreviated initial operative procedure with temporary abdominal closure; In major trauma, where it was initially described, the main goal of DCS is the prevention of the 'lethal triad': acidosis, hypothermia, and coagulopathy [82]. In secondary peritonitis, DCS aims at controlling the source of infection in the fastest and least invasive way, leaving completion surgery for a subsequent phase after adequate patient stabilization in the ICU [83].…”

Section: Considerationsmentioning

confidence: 99%

Management of perforated diverticulitis with generalized peritonitis. A multidisciplinary review and position paper

et al. 2020

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Perforated diverticulitis is an emergent clinical condition and its management is challenging and still debated. The aim of this position paper was to critically review the available evidence on the management of perforated diverticulitis and generalized peritonitis in order to provide evidence-based suggestions for a management strategy. Four Italian scientific societies (SICCR, SICUT, SIRM, AIGO), selected experts who identified 5 clinically relevant topics in the management of perforated diverticulitis with generalized peritonitis that would benefit from a multidisciplinary review. The following 5 issues were tackled: 1) Criteria to decide between conservative and surgical treatment in case of perforated diverticulitis with peritonitis; 2) Criteria or scoring system to choose the most appropriate surgical option when diffuse peritonitis is confirmed 3); The appropriate surgical procedure in hemodynamically stable or stabilized patients with diffuse peritonitis; 4) The appropriate surgical procedure for patients with generalized peritonitis and septic shock and 5) Optimal medical therapy in patients with generalized peritonitis from diverticular perforation before and after surgery. In perforated diverticulitis surgery is indicated in case of diffuse peritonitis or failure of conservative management and the decision to operate is not based on the presence of extraluminal air. If diffuse peritonitis is confirmed the choice of surgical technique is based on intraoperative findings and the presence or risk of severe septic shock. Further prognostic factors to consider are physiological derangement, age, comorbidities, and immune status. In hemodynamically stable patients, emergency laparoscopy has benefits over open surgery. Options include resection and anastomosis, Hartmann’s procedure or laparoscopic lavage. In generalized peritonitis with septic shock, an open surgical approach is preferred. Non-restorative resection and/or damage control surgery appear to be the only viable options, depending on the severity of hemodynamic instability. Multidisciplinary medical management should be applied with the main aims of controlling infection, relieving postoperative pain and preventing and/or treating postoperative ileus. In conclusion, the complexity and diversity of patients with diverticular perforation and diffuse peritonitis requires a personalized strategy, involving a thorough classification of physiological derangement, staging of intra-abdominal infection and choice of the most appropriate surgical procedure.

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The Bucharest ESTES consensus statement on peritonitis

Cited by 5 publications

References 117 publications

A modern view of the causes and mechanisms of the development of acute disseminated peritonitis

A modern view of the causes and mechanisms of the development of acute disseminated peritonitis

Sepsis‑induced cardiac dysfunction and pathogenetic mechanisms (Review)

Management of perforated diverticulitis with generalized peritonitis. A multidisciplinary review and position paper

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