ICU approach to perforation, abscess, postoperative leak, ischemic bowel and complicated intra-abdominal infection
Perforation, anastomotic leak, abscess, ischemic bowel and infected collections require rapid localization. CT with IV contrast is often central when the patient can safely undergo imaging, but unstable patients may need immediate operative evaluation.
Drain infected collections, repair or resect perforated/ischemic bowel, and control ongoing contamination. Do not continue escalating antibiotics while an uncontrolled anatomical source persists.
Serial abdominal examination, organ function and imaging when indicated are essential. Coordinate surgery, interventional radiology, infectious diseases and nutrition teams.
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