Peritonitis terciaria: tan difícil de definir como de tratar / Tertiary peritonitis: as difficult to define as it is to treat

En la evolución de los pacientes con infecciones intra-abdominales complicadas la peritonitis terciaria constituye la forma más tardía y grave. La mayor dificultad radica en dar una definición común, precisa y consensuada para conocer cuándo realizar su diagnóstico y cómo poder evitarla y/o tratarla. Esta entidad requiere un tratamiento quirúrgico precoz y repetido, una terapia antibiótica de amplio espectro frente a microorganismos multirresistentes y unas medidas de soporte sistémico intensivo. A pesar de todo ello el pronóstico es malo ya que presenta una mortalidad que puede llegar hasta el 60% siendo la prevención la medida más importante para evitar su desarrollo. En este artículo hemos realizado una revisión específica de la peritonitis terciaria, de las definiciones aceptadas, de los factores de riesgo, de su fisiopatología, de la flora microbiológica implicada y de su tratamiento (AU)

Tertiary peritonitis is the most delayed and severe outcome of patients with complicated intra-abdominal infections. The major difficulty lies in giving a common, precise and consensus definition in order to know when to make its diagnosis and how it can be avoided and/or treated. This condition requires early and repeated surgery, wide spectrum antibiotic therapy against multi-resistant bacteria and intensive systemic support measures. Despite all this, the prognosis is extremely poor since it has a mortality which can reach up to 60%, with preventions being the most important measure to avoid it developing. In this article, we have made a specific review of tertiary peritonitis, of the accepted definitions, the risk factors, its pathophysiology, the microbiological flora involved, and its treatment (AU)

[Tertiary peritonitis: as difficult to define as it is to treat]. / Peritonitis terciaria: tan difícil de definir como de tratar.

Tertiary peritonitis is the most delayed and severe outcome of patients with complicated intra-abdominal infections. The major difficulty lies in giving a common, precise and consensus definition in order to know when to make its diagnosis and how it can be avoided and/or treated. This condition requires early and repeated surgery, wide spectrum antibiotic therapy against multi-resistant bacteria and intensive systemic support measures. Despite all this, the prognosis is extremely poor since it has a mortality which can reach up to 60%, with preventions being the most important measure to avoid it developing. In this article, we have made a specific review of tertiary peritonitis, of the accepted definitions, the risk factors, its pathophysiology, the microbiological flora involved, and its treatment.