Role of Surgical Intervention in the Prevention and Therapy of Sepsis

Abstract

Due to almost two square meters of surface, peritoneal inflammation caused by intraabdominal septic foci quickly leads to involvement of the entire organism within the disease process. If the significant peritoneal host defense mechanisms fail, its enormous surface turns into a threatening opponent. Assimilation of several liters of fluid leads to decreased intravascular volume and hypovolemic shock. Increased intraabdominal pressure, through peritoneal edema, produces compression of the lower lung. Both mechanisms lead to hypoxia and thereby insufficient tissue perfusion. In connection with cellular and humoral reactions permeability of the bowel wall increases resulting in penetration of bacteria and endotoxins into the bloodstream with consecutive failure of multiple organ systems. Thus, the disease process is not limited to its origin, rather, it spreads to become a disorder of the entire organism, i.e., a sepsis syndrome.