By Joseph Solomkin, Thomas L. Husted, Hannes Wacha
A clinician's instruction for intra-abdominal infections written by means of specialists within the field.
- A handbook to assist physicians to fast realize and higher comprehend the pathogenesis of intra-abdominal
- comprises a number of top quality black and white and colour images from real-life scientific cases
- Adheres to an easy layout to function crucial and fast reference advisor for all non-surgical citizens and physicians
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Extra resources for Clinician's Manual on Intra-abdominal Infections
Initial therapy consists of discontinuing the precipitating antibiotic and administering intravenous fluid hydration. Interventional approaches Operative C. difficile colitis can progress to toxic megacolon or perforation with signs of sepsis and resistance to medical therapy. Operative therapy in this circumstance involves subtotal colectomy with end ileostomy and delayed reanastomosis. 23). However, metronidazole as a primary treatment option can fail or result in early recurrence. Alternative therapy is oral vancomycin (4 x 125 mg/day) which should be indicated especially in severe cases; intravenous vancomycin (same as oral dosage) is another alternative if oral medications are not tolerated.
Once the acute episode has resolved, screening colonoscopy and a high-fiber diet are recommended. Complicated diverticulitis Moderate or severe attacks of diverticulitis should be treated as an inpatient with intravenous broad-spectrum antibiotics, bowel rest, and pain control. Resolution of fever, correction of elevated white blood cell count and improvement of peritoneal signs determine resolution of the acute phase. In cases of complicated diverticulitis that do not resolve, intervention is warranted.
In addition, broad-spectrum antibiotics effective against colonic flora are essential to guard against the possibility of bacterial translocation from the ischemic colon. 15 Endoscopic appearance of ischemic colitis. Ischemic colitis enters into the differential diagnosis of inflammatory bowel disease, particularly in elderly patients. The etiology is usually nonocclusive ischemic damage to the colon as a result of hypotension or hypoperfusion. Iatrogenic injury to, or ligation of, the inferior mesenteric artery may also result in ischemic colitis.
Clinician's Manual on Intra-abdominal Infections by Joseph Solomkin, Thomas L. Husted, Hannes Wacha