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2002, Número 4

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Med Crit 2002; 16 (4)


Sepsis abdominal

Juan Pedro Chávez PJP

Idioma: Español
Referencias bibliográficas: 42
Paginas: 124-135
Archivo PDF: 94.83 Kb.


RESUMEN

La sepsis abdominal tiene una incidencia similar a la neumonía y bacteremia en la unidad de cuidados intensivos y por lo tanto el pronóstico y el costo de atención son similares. La sepsis abdominal es una respuesta sistémica a un proceso infeccioso localizado. La peritonitis aguda tiene elevada mortalidad y es la primera etapa de la sepsis abdominal; los sobrevivientes a ésta desarrollan abscesos siete días más tarde. Las principales manifestaciones de la peritonitis son dolor abdominal, fiebre, resistencia muscular y silencio abdominal. Son herramientas útiles para completar el diagnóstico de sepsis abdominal la ultrasonografía, tomografía computada y estudios con radioisótopos. El tratamiento de la sepsis abdominal incluye el drenaje de los focos infecciosos, apoyo sistémico y el empleo de antibióticos específicos. Son factores de mal pronóstico: edad > 65 años, número de cirugías (más de dos), peritonitis generalizada, desnutrición, choque séptico y falla orgánica múltiple.


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