Peritonitis and intraabdominal abscesses

1. Big picture

Peritonitis and intraabdominal abscesses are surgical infection/source-control topics. The examiner wants you to think like this:

Severe abdominal pain ± sepsis
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Is there peritoneal irritation, perforation, ischemia, leak, or abscess?
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Resuscitate immediately
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Start broad-spectrum antibiotics early
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Find the source by clinical exam + labs + CT if stable
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Control the source: operate, drain, resect, repair, divert, or percutaneously drain

Core oral-exam sentence:

Peritonitis is inflammation of the peritoneum, most often due to bacterial contamination from gastrointestinal perforation, ischemia, postoperative leak, or inflammatory organ perforation. Treatment is urgent resuscitation, broad-spectrum antibiotics, and source control. Intraabdominal abscess is a localized pus collection, usually treated by image-guided percutaneous drainage plus antibiotics, or surgery if drainage fails, the source requires operation, or the patient has generalized peritonitis.

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