Postoperative Peritonitis: Etiology, Diagnosis, and Treatment

  • Torsten Herzog
  • Waldemar Uhl
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)


Postoperative peritonitis is still one of the most common causes of postoperative mortality after abdominal surgery. Over the last three decades, improvements in surgical technique and intensive care management have reduced the frequency of postoperative peritonitis, especially after major abdominal surgery. Still, mortality from abdominal sepsis is high, and successful treatment of postoperative peritonitis remains a challenge. Early diagnosis and appropriate and immediate initiation of an effective therapy is the cornerstone of successful treatment of postoperative peritonitis. The treatment of postoperative peritonitis relays on three principles: focus elimination, intensive care management, and antibiotic therapy. While treatment options for source control and intensive care management constantly improved, rapidly continuing emergence of postoperative peritonitis with resistant microorganisms is responsible for an increasing number of treatment failures among surgical patients.

The aim of this book chapter is to describe the most common causes of postoperative peritonitis. Furthermore, we aimed to identify the best strategies to prevent and treat postoperative peritonitis with special attention to antibiotic-resistant microorganisms and treatment options for postoperative peritonitis secondary to antibiotic-resistant microorganisms.


Severe intraabdominal infection Complicated intraabdominal infection Abdominal sepsis Peritonitis Multidrug resistance Antibiotic therapy Antibiotic resistance 


Conflict of Interest

Both authors certify that they do not have any conflict of interest or financial association conflicting with the presented manuscript.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgery, St. Josef HospitalRuhr-University BochumBochumGermany

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